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RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study

Introduction:With several single-use ureteroscopes now available, our aim was to analyze and compare data obtained globally from high-volume centers using both disposable and reusable flexible ureteroscopes and see if indeed in real-world practice either scope has a distinct advantage. Methods:Retro...

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Main Authors: Gauhar, Vineet, Chai, Chu Ann, Chew, Ben H., Singh, Abhishek, Castellani, Daniele, Tailly, Thomas, Emiliani, Esteban, Keat, William Ong Lay, Ragoori, Deepak, Lakmichi, Mohamed Amine, Teoh, Jeremy Yuen-Chun, Traxer, Olivier, Somani, Bhaskar Kumar
Format: Article
Published: SAGE Publications 2023
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R Medicine (General)
Online Access:http://eprints.um.edu.my/47190/
https://doi.org/10.1177/17562872231158072
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spelling my.um.eprints.471902024-11-28T02:21:32Z http://eprints.um.edu.my/47190/ RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study Gauhar, Vineet Chai, Chu Ann Chew, Ben H. Singh, Abhishek Castellani, Daniele Tailly, Thomas Emiliani, Esteban Keat, William Ong Lay Ragoori, Deepak Lakmichi, Mohamed Amine Teoh, Jeremy Yuen-Chun Traxer, Olivier Somani, Bhaskar Kumar R Medicine (General) Introduction:With several single-use ureteroscopes now available, our aim was to analyze and compare data obtained globally from high-volume centers using both disposable and reusable flexible ureteroscopes and see if indeed in real-world practice either scope has a distinct advantage. Methods:Retrospective analysis was performed on the FLEXOR registry, which was created as a TOWER group (Team of Worldwide Endourological Researchers, research wing of the Endourological Society) endeavor. Patients who underwent retrograde intrarenal surgery (RIRS) for renal stones from January 2018 to August 2021 were enrolled from 20 centers globally. A total of 6663 patients whose data were available for analysis were divided into Group 1 (Reusable scopes, 4808 patients) versus Group 2 (Disposable scopes, 1855 patients). Results:The age and gender distribution were similar in both groups. The mean stone size was 11.8 mm and 9.6 mm in Groups 2 and 1, respectively (p < 0.001). Group 2 had more patients with >2 cm stones, lower pole stones and of higher Hounsfield unit. Thulium fiber laser (TFL) was used more in Group 2 (p < 0.001). Patients in Group 2 had a slightly higher stone-free rate (SFR) (78.22%) and a lower number of residual fragments (RFs) compared with Group 1 (p < 0.001). The need for further treatments for RF and overall complications was comparable between groups. On multivariate analysis, overall complications were more likely to occur in elderly patients, larger stone size, lower pole stones, and were also more when using disposable scopes with longer operative time. RFs were significantly higher (p < 0.001) for lower pole, larger, harder, multiple stones and in elderly. Conclusion:Our real-world practice observations suggest that urologists choose disposable scopes for bigger, lower pole, and harder stones, and it does indeed help in improving the single-stage SFR if used correctly, with the appropriate lasers and lasing techniques in expert hands. SAGE Publications 2023 Article PeerReviewed Gauhar, Vineet and Chai, Chu Ann and Chew, Ben H. and Singh, Abhishek and Castellani, Daniele and Tailly, Thomas and Emiliani, Esteban and Keat, William Ong Lay and Ragoori, Deepak and Lakmichi, Mohamed Amine and Teoh, Jeremy Yuen-Chun and Traxer, Olivier and Somani, Bhaskar Kumar (2023) RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study. Therapeutic Advances in Urology, 15. p. 17562872231158072. ISSN 1756-2872, DOI https://doi.org/10.1177/17562872231158072 <https://doi.org/10.1177/17562872231158072>. https://doi.org/10.1177/17562872231158072 10.1177/17562872231158072
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine (General)
spellingShingle R Medicine (General)
Gauhar, Vineet
Chai, Chu Ann
Chew, Ben H.
Singh, Abhishek
Castellani, Daniele
Tailly, Thomas
Emiliani, Esteban
Keat, William Ong Lay
Ragoori, Deepak
Lakmichi, Mohamed Amine
Teoh, Jeremy Yuen-Chun
Traxer, Olivier
Somani, Bhaskar Kumar
RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study
description Introduction:With several single-use ureteroscopes now available, our aim was to analyze and compare data obtained globally from high-volume centers using both disposable and reusable flexible ureteroscopes and see if indeed in real-world practice either scope has a distinct advantage. Methods:Retrospective analysis was performed on the FLEXOR registry, which was created as a TOWER group (Team of Worldwide Endourological Researchers, research wing of the Endourological Society) endeavor. Patients who underwent retrograde intrarenal surgery (RIRS) for renal stones from January 2018 to August 2021 were enrolled from 20 centers globally. A total of 6663 patients whose data were available for analysis were divided into Group 1 (Reusable scopes, 4808 patients) versus Group 2 (Disposable scopes, 1855 patients). Results:The age and gender distribution were similar in both groups. The mean stone size was 11.8 mm and 9.6 mm in Groups 2 and 1, respectively (p < 0.001). Group 2 had more patients with >2 cm stones, lower pole stones and of higher Hounsfield unit. Thulium fiber laser (TFL) was used more in Group 2 (p < 0.001). Patients in Group 2 had a slightly higher stone-free rate (SFR) (78.22%) and a lower number of residual fragments (RFs) compared with Group 1 (p < 0.001). The need for further treatments for RF and overall complications was comparable between groups. On multivariate analysis, overall complications were more likely to occur in elderly patients, larger stone size, lower pole stones, and were also more when using disposable scopes with longer operative time. RFs were significantly higher (p < 0.001) for lower pole, larger, harder, multiple stones and in elderly. Conclusion:Our real-world practice observations suggest that urologists choose disposable scopes for bigger, lower pole, and harder stones, and it does indeed help in improving the single-stage SFR if used correctly, with the appropriate lasers and lasing techniques in expert hands.
format Article
author Gauhar, Vineet
Chai, Chu Ann
Chew, Ben H.
Singh, Abhishek
Castellani, Daniele
Tailly, Thomas
Emiliani, Esteban
Keat, William Ong Lay
Ragoori, Deepak
Lakmichi, Mohamed Amine
Teoh, Jeremy Yuen-Chun
Traxer, Olivier
Somani, Bhaskar Kumar
author_facet Gauhar, Vineet
Chai, Chu Ann
Chew, Ben H.
Singh, Abhishek
Castellani, Daniele
Tailly, Thomas
Emiliani, Esteban
Keat, William Ong Lay
Ragoori, Deepak
Lakmichi, Mohamed Amine
Teoh, Jeremy Yuen-Chun
Traxer, Olivier
Somani, Bhaskar Kumar
author_sort Gauhar, Vineet
title RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study
title_short RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study
title_full RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study
title_fullStr RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study
title_full_unstemmed RIRS with disposable or reusable scopes: does it make a difference? Results from the multicenter FLEXOR study
title_sort rirs with disposable or reusable scopes: does it make a difference? results from the multicenter flexor study
publisher SAGE Publications
publishDate 2023
url http://eprints.um.edu.my/47190/
https://doi.org/10.1177/17562872231158072
_version_ 1817841985681096704
score 13.235796

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