f-URS – The Impact of the Learning Curve in Stone Free and Complication Rates

• Published in: Romanian journal of urology Vol. 22; no. 1; pp. 45 - 50
• Main Authors: Rascu, S, Sima, C, Toma, C, Aurelian, J, Diaconescu, D, Petca, R, Constantin, T, Danau, R, Predoiu, G, Merticariu, M, Jinga, V, Badescu, D
• Format: Journal Article
• Language: English
• Published: Bucharest Romanian Journal of Urology 01.01.2023
• Subjects: Endoscopy; General anesthesia; Intubation; Kidney stones; Lasers; Learning curves; Lithotripsy; Patients; Stents; Surgeons; Surgery; Surgical outcomes; Urinary tract diseases; Urogenital system; Urology
• ISSN: 1842-2187

Flexible ureterorenoscopy (f-URS) gained a lot of field in treating reno-ureteral lithiasis, with a clear indication for kidney stones smaller than 20 mm with an acceptable stone free rate (SFR) compared to its complications, but also with a specific learning curve.The goal of this study is to investigate the learning curve in f-URS and its impact on success and complication rates. Complication rate and hospital stay showed no major difference between the two patient groups, but the SFR was significantly improved in the latest study group-86.66% versus 66%. Key-words: flexible ureteroscopy, f-URS, learning curve, SFR, stone free rate INTRODUCTION AND OBJECTIVES Since its introduction and perfectioning as a surgical method at the beginning of the 1980s, flexible ureterorenoscopy (f-URS) gained a lot of field as the minimally invasive, endoscopic surgery used for the diagnosis and treatment of several pathologies of the upper urinary tract, with a main indication in treating reno-ureteral lithiasis. f-URS might be the endoscopic surgery of choice for kidney stones with the maximum dimension less than 20 mm, with better stone free rates (SFR) compared to Extracorporeal Shock Wave Lithotripsy (ESWL) and with lower complication rates than percutaneous nephrolithotomy (PCNL), according to the European Urology Association (EAU) Guidelines on Urolithiasis and several other studies published in the literature [1-3]. According to the assessed characteristics, the two study groups were quite superposable, with comparable age, sex, BMI, stone location, stone density, and stone sizes, with a p-value that showed no significance from a statistical point of view.