Objective: To assess our experience in flexible ureteroscopy (fURS) in major ambulatory surgery (MAS) and to detect variables related to unplanned medical assistance after surgery.
Material & methods: We conducted a retrospective study among patients with renal stones undergoing a fURS from 2014 to 2019 in MAS at our hospital.
Variables: Age, gender, ASA physical status, type of anesthetic technique performed, stone characteristics, influence of double J stent before or after surgery, and postoperative complications according to the Clavien-Dindo modified classification. We evaluated variables related to hospital readmission or visit to the emergency room after surgery.
Results: A total of 222 consecutive fURS for stone disease were performed in MAS. Patients' average age was 52.9 ± 13.91 years old. The mean operating time was 57.86 ± 21.11 minutes. The mean stone size was 1.92 ± 1.43 with a diameter of 10.01 ± 4.24 mm. 47.3% of patients had a double J stent before fURS, and in 35.14% of cases, a stent was placed after surgery. 7.65% of patients required unplanned hospitalization. 14.86% of patients presented to the emergency room in the following month after surgery. Among them, one-third consulted for symptoms related to the double J. Patients who carried a double J stent before the fURS had 64% less risk of visiting the emergency department in the following month after surgery [OR = 0,363; IC95% (0.153-0.798)]. All other variables (age, gender, operating time...) did not modify the risk of unplanned medical assistance.
Conclusion: The low complication rate following flexible ureteroscopy allows its performance as an ambulatory surgery. Patients who carry double J stent before the procedure have less risk of requiring unplanned medical assistance after the surgery.
Keywords: flexible ureteroscopy; major ambulatory surgery; retrograde intrarrenal surgery.