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    Predictive Modeling Is a Reliable Indicator in Determining Excessive Renal Mobility Single-Center Randomized Study
    (Mary Ann Liebert, Inc, 2025) Dogan, Cagri; Ozgur, Cihan; Sahin, Mehmet Fatih; Siddikoglu, Duygu; Topkac, Erdem Can; Yazici, Cenk Murat
    Purpose: Excessive kidney mobility is an underestimating challenge for surgeons during retrograde intrarenal surgery (RIRS) and extracorporeal shock wave lithotripsy (ESL). There is no technique approved as a gold standard procedure for reducing excessive kidney mobility. The study aimed to uncover predictive factors for determining excessive renal mobility by utilizing clinicodemographic characteristics and noncontrast computed tomography (NCCT) data. Materials and Methods: The patients were categorized into two groups based on the presence of excessive renal mobility. Patients were scanned with a 16-channel, multislice NCCT, and images were captured utilizing a 16 x 1.25 mm collimation, 5 mm slice thickness. Many parameters including the origin angle of the renal artery, renal artery, vein length, diameter, the area and length of the psoas muscle, and perirenal and pararenal fatty tissue were measured on the images and analyzed. The data were analyzed using multivariate logistic regression, and the receiver operating characteristic curve model and we used predictive modeling based on three significant parameters. Results: Between May 2023 and May 2024, a total of 140 patients with and without excessive renal mobility enrolled into study. After multivariate analysis, increasing renal vein length and renal artery origin angle results in higher renal motility (odds ratio [OR]: 0.982; 95% confidence interval [CI]: 0.966-0.998; p = 0.030 and OR: 0.973; 95% CI: 0.948-0.999; p = 0.044; respectively). It also observed that an increase in tidal volume led to a reduction in renal mobility (OR: 1.015; 95% CI: 1.007-1.024; p = 0.001). Predictive modeling was designed based on these outcomes. This predictive modeling accurately estimates the presence of excessive renal mobility with improved 59% specificity and 65% sensitivity (p < 0.001, area under the curve 0.757; CI: 0.671-0.843). Conclusion: Physicians may predict the presence of excessive renal mobility via the predictive modeling mentioned in the current article. They may perform manipulations to reduce kidney mobility prior to ESL and RIRS.
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    Öğe
    The Efficacy and Safety of Retrograde Intrarenal Surgery: A Multi-Center Experience of the RIRSearch Group Study
    (Galenos Publ House, 2023) Akgul, Murat; Cakir, Hakan; Ozman, Oktay; Cinar, Onder; Basatac, Cem; Siddikoglu, Duygu; Dogan, Cagri
    Objective: We reported the results of retrograde intrarenal surgeries (RIRS) according to multi-center experience and to assess the efficacy and safety of this procedure. Materials and Methods: A total of 1067 patients to whom RIRS operations were performed between 2016 and 2021 were included in the study. The demographic and clinical features of patients, stone properties, per-operative, and post-operative results were analyzed retrospectively. Additionally, the success and complication rates of RIRS according to the clinical and demographic properties of the patients were analyzed. Results: The mean age, stone volume, operation time, and hospitalization time were 46.8 & PLUSMN;15.4, 1011 mm3 (min 19 mm3- max 12.483 mm3), 67.4 & PLUSMN;30.8 min, and 1.83 & PLUSMN;2.3 days, respectively. The stone-free (success) rate after RIRS was 74.5%. In multivariate analysis, pre-op pyuria, number of stones, and stone volume had a significant effect on success. There were 251 (23.5%) patients with post-operative complications. The most common complications were hematuria, fever, and urinary tract infections; they comprised 86.8% of all complications. The number of stones, pre-op ESL, and absence of pre-operative DJ stent had a significant effect on complications in multivariate analysis. Conclusion: Retrograde intrarenal surgery is an efficient minimal invasive procedure for treating urinary system stone disease with low morbidity and high success rates. Although the complication rates are mostly insignificant, there may also be severe vital complications.