Abstract：
To compare same-sitting bilateral vs unilateral retrograde intrarenal surgery (RIRS) in elderly patients, focusing on postoperative complications and stone-free rates (SFR).
Data from 2 multicenter databases, FLEXible ureteroscopy Outcomes Registry (FLEXOR) (unilateral RIRS) and same sitting bilateral-retrograde intrarenal surgery (SSB-RIRS) (bilateral RIRS), were analyzed, considering only patients aged 70+ with preoperative computed tomography. Patients were categorized into Group 1 (bilateral RIRS) and Group 2 (unilateral RIRS). Follow-up included imaging assessments and secondary treatments as needed.
Group 1 included 146 patients, while group 2 had 495. Group 1\'s patients were slightly older and had a higher prevalence of recurrent stone formation. Group 2 often underwent RIRS for incidental stones. Group 1 had larger and more pelvic stones. Laser lithotripsy and total operation times were significantly longer in Group 1. Group 2 had significantly higher overall stone-free rates, although there were no significant differences in ancillary procedures for residual fragments. Group 1 experienced more pelvicalyceal injuries needing stenting, postoperative fever, and post-op hematuria not requiring transfusion.
In conclusion, bilateral RIRS can be carefully considered in elderly patients. Preoperative counseling is essential for both primary and repeat RIRS procedures, and further research is needed to optimize instrument and laser strategies for better outcomes in elderly RIRS patients.
Data from 2 multicenter databases, FLEXible ureteroscopy Outcomes Registry (FLEXOR) (unilateral RIRS) and same sitting bilateral-retrograde intrarenal surgery (SSB-RIRS) (bilateral RIRS), were analyzed, considering only patients aged 70+ with preoperative computed tomography. Patients were categorized into Group 1 (bilateral RIRS) and Group 2 (unilateral RIRS). Follow-up included imaging assessments and secondary treatments as needed.
Group 1 included 146 patients, while group 2 had 495. Group 1\'s patients were slightly older and had a higher prevalence of recurrent stone formation. Group 2 often underwent RIRS for incidental stones. Group 1 had larger and more pelvic stones. Laser lithotripsy and total operation times were significantly longer in Group 1. Group 2 had significantly higher overall stone-free rates, although there were no significant differences in ancillary procedures for residual fragments. Group 1 experienced more pelvicalyceal injuries needing stenting, postoperative fever, and post-op hematuria not requiring transfusion.
In conclusion, bilateral RIRS can be carefully considered in elderly patients. Preoperative counseling is essential for both primary and repeat RIRS procedures, and further research is needed to optimize instrument and laser strategies for better outcomes in elderly RIRS patients.
摘要：
目的：比较老年患者相同坐位双侧与单侧逆行肾内手术（RIRS），重点关注术后并发症和结石发生率（SFR）。
方法：来自2个多中心数据库的数据，输尿管镜检查结果登记（FLEXOR）（单侧RIRS）和相同的双侧逆行肾内手术（SSB-RIRS）（双侧RIRS），被分析,仅考虑70岁以上的术前计算机断层扫描患者。患者分为第1组（双侧RIRS）和第2组（单侧RIRS）。随访包括影像学评估和必要的二次治疗。
结果：第1组包括146名患者，而第2组有495例。第1组患者年龄稍大，结石复发发生率较高。第2组经常因偶然结石而接受RIRS。第1组的骨盆结石更大，更多。第1组激光碎石术和总手术时间明显更长。第2组的整体无结石率明显较高，尽管残留片段的辅助程序没有显着差异。第1组经历了更多的骨盆损伤，需要支架置入，术后发热,术后血尿不需要输血。
结论：结论：老年患者可以仔细考虑双侧RIRS。术前咨询对于主要和重复RIRS程序都是必不可少的，需要进一步的研究来优化仪器和激光策略,以更好地治疗老年RIRS患者.
方法：来自2个多中心数据库的数据，输尿管镜检查结果登记（FLEXOR）（单侧RIRS）和相同的双侧逆行肾内手术（SSB-RIRS）（双侧RIRS），被分析,仅考虑70岁以上的术前计算机断层扫描患者。患者分为第1组（双侧RIRS）和第2组（单侧RIRS）。随访包括影像学评估和必要的二次治疗。
结果：第1组包括146名患者，而第2组有495例。第1组患者年龄稍大，结石复发发生率较高。第2组经常因偶然结石而接受RIRS。第1组的骨盆结石更大，更多。第1组激光碎石术和总手术时间明显更长。第2组的整体无结石率明显较高，尽管残留片段的辅助程序没有显着差异。第1组经历了更多的骨盆损伤，需要支架置入，术后发热,术后血尿不需要输血。
结论：结论：老年患者可以仔细考虑双侧RIRS。术前咨询对于主要和重复RIRS程序都是必不可少的，需要进一步的研究来优化仪器和激光策略,以更好地治疗老年RIRS患者.
