YẾU TỐ ẢNH HƯỞNG KẾT QUẢ ĐIỀU TRỊ SỎI THẬN BẰNG NỘI SOI TÁN SỎI ỐNG SOI MỀM TẠI BỆNH VIỆN TRƯỜNG ĐẠI HỌC Y DƯỢC CẦN THƠ

Abstract

Background: Retrograde intrarenal surgery (RIRS) using a flexible ureteroscope and laser lithotripsy has become a primary treatment option for kidney stones due to its high efficacy and safety. However, surgical outcomes are influenced by various factors related to stone characteristics and pelvicalyceal anatomy. Objectives: To evaluate the treatment outcomes and investigate factors affecting the stone-free rate (SFR) in patients undergoing RIRS at Can Tho University of Medicine and Pharmacy Hospital. Materials and methods: A prospective, non-controlled clinical intervention study was conducted on 75 patients with kidney stones treated with RIRS from May 2025 to May 2026. Results: The mean age was 50.4 ± 10.7 years, with males accounting for 54.7%. The overall success rate at 3 months was 90.7% (complete stone-free rate 82.7%, clinically insignificant residual fragments 8.0%). Factors negatively correlating with the SFR included multiple stones (73.9% vs. 86.5%, p=0.020), an acute infundibulopelvic angle (50.0% vs. 87.7% for moderate angle, p<0.001), larger stone size (p<0.001), and high stone density (p<0.001). Multivariate regression identified stone size and Hounsfield Unit (HU) density as independent prognostic factors increasing the risk of residual stones (p<0.001). Conclusions: RIRS is a safe and highly effective procedure. Large stone size and high stone density are the main factors reducing the complete SFR, necessitating careful preoperative imaging assessment.