A Novel Flexible Ureteroscopy with Intelligent Control of Renal Pelvic Pressure: An Initial Experience of 93 Cases

Deng, Xiaolin; Song, Leming; Xie, Donghua; Fan, Daiming; Zhu, Ling; Yao, Lei; Wang, Xiaolin; Liu, Shaohua; Yong-hua, Zhang; Liao, Xiaohui; Liu, Shengfeng; Peng, Zhe; Hu, Min; Zhu, Xianxin; Huang, Jianrong; Liu, Tairong; Du, Chengchao; Guo, Shu-Lin; Yang, Zhongsheng; Peng, Guang-Hua; Ye, Zhangqun

doi:10.1089/end.2015.0770

Cited by 57 publications

(47 citation statements)

References 24 publications

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“…Once the intra-luminal pressure increases, perfusion will be terminated automatically to prevent risk arising from high intrapelvic pressure, such as infection [20]. The larger the ureteral stones, the longer time the lithotripsy takes and the higher probability of systemic inflammatory response syndrome occurs [21, 22]. Serum PCT, IL-6, and BET are usually used as infectious indicators.…”

Section: Discussionmentioning

confidence: 99%

A study on the clinical application of a patented perfusion and suctioning platform and ureteral access sheath in the treatment of large ureteral stones below L4 level

Song

et al. 2018

Int Urol Nephrol

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Purpose The purpose of the study was to evaluate the efficacy and safety of a patented perfusion and suctioning platform and ureteral access sheath in the treatment of large ureteral stones (≥ 1.5 cm) below L4 level. Methods We recruited 122 patients with large ureteral stones below L4 level at our hospital from December 2014 to June 2017. The patients were randomly divided into the study and control groups. Multiple operative and perioperative parameters were compared between the two groups. Results The study group had shorter operation time, less cases of postoperative fever, lower serum levels of PCT, IL-6 and BET within 24 h after surgery, as well as less number of cases receiving secondary surgery than the control group. Moreover, the former had a significantly higher stone clearance rate than the latter ( P < 0.05; t -test or χ 2 test). Conclusions The patented perfusion and suctioning platform and ureteral access sheath are safe and effective in treating large ureteral stones (≥ 1.5 cm) below L4 level.

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Section: Discussionmentioning

confidence: 99%

A study on the clinical application of a patented perfusion and suctioning platform and ureteral access sheath in the treatment of large ureteral stones below L4 level

Song

et al. 2018

Int Urol Nephrol

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“…The use of UAS is widely recognised as a technique utilised to keep the intrarenal pressure low when performing FURS for larger and more complex stones, although some authors advocate its use for most renal stones [6][7][8]. Managing intrarenal pressure seems to prevent acute kidney injury and possibly also reduces the risk of sepsis [10][11][12][13][14]. Operative times greater than 60 min with irrigation pressure > 20 cmH 2 O is linked with renal damage, which is further worsened by peak pressures during forced irrigation, all of which is partly negated with the use of UAS [12].…”

Section: Introductionmentioning

confidence: 99%

Impact of ureteral access sheath on renal stone treatment: Prospective comparative non-randomised outcomes over a 7-year period

Lima¹,

Reeves²,

Geraghty³

et al. 2019

European Urology Supplements

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Purpose To compare the outcomes (stone free rate and complications) of renal stone treatment with and without the use of ureteral access sheath (UAS). The worldwide use of UAS has risen over the last decade; however, questions still remain on the safety and outcomes with its use. We wanted to look at the role of UAS for treatment of consecutive renal stones over a 7-year period. Methods The outcomes of flexible ureteroscopy and stone treatment (FURS) for renal stones with and without the use of UAS was prospectively compared from March 2012 to July 2018. Patients were divided into two groups: group-1 where UAS was used for stone treatment and group-2 where a UAS was not used. Data were collected prospectively on consecutive patients for demographics, stone size, location and number, pre and post-operative stent usage, operative time duration, stone free rate (SFR), length of stay and complications. Results During the study period, 338 patients underwent FURS for renal stones, of which a UAS was used for 203 (60%) patients. The mean age of patients was 56 years (range 2-89 years) with a male:female ratio of 204:134. The mean cumulative stone size and the mean number of stones was 16.5 ± 10.8 mm and 11.37 ± 8.08 mm (P < 0.001), and 2.17 ± 1.99 and 1.66 ± 1.50 (P = 0.009) for groups 1 and 2 respectively. The pre and post-operative stent insertion rates were similar in the two groups. The procedural time was longer in group-1 (54.8 ± 25.8 min) compared to group-2 (41.3 ± 22.2 min) (P < 0.001). The SFR for group-1 (88%) was slightly lower than group-2 (94%) although this was not statistically significant (P = 0.07). There were no intra-operative complications in either of the groups. Post-operative complications were seen in eight patients in group-1 (7 Clavien I/II and 1 Clavien IVa) and two patients in group-2 (Clavien I) (P = 0.19). Conclusion The use of UAS for renal stones is safe with no intra-operative complications noted in our series. Good stone-free rates were obtained for large and multiple renal stones with a small risk of minor complications post-operatively.

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“…The ureteral access sheath in place may drain the majority of fluids to maintain a low intrarenal pressure in FURSL procedure [19]. The application of intelligent pressure-controlled devices may also be beneficial for maintenance of low pressure, which increases hospital costs for patients [20,21]. In this study, the 12/14F ureteral access sheath was placed for great drainage effect.…”

Section: Discussionmentioning

confidence: 96%

Flexible Ureteroscopic Lithotripsy Based on the Concept of Enhanced Recovery After Surgery

Shu

Zhang

et al. 2021

Preprint

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Background: To evaluate the efficacy of flexible ureteroscopic lithotripsy (FURSL) based on the concept of enhanced recovery after surgery (ERAS).Methods: 435 patients with upper urinary calculi between 2017-2020 were retrospectively analysed and assigned to ERAS group (ERAS management) and control group (traditional management). Operative time, postoperative ambulation time, postoperative hospital stay, total cost of hospitalization, postoperative complications and stone removal were compared. Results: 427 cases were successfully performed FURSL procedure with 4 cases of ERAS group (n = 216) and 4 cases of control group (n = 219) failed respectively. No postoperative complications occurred in either group except for fever and hematuria. There were no significant difference in postoperative fever and stone removal between the two groups (all p > 0.05). The patients in ERAS group had shorter operative time, shorter postoperative ambulation time, less postoperative severe hematuria, shorter postoperative hospital stay and lower total cost of hospitalization than those in control group (all p < 0.05).Conclusions: FURSL based on the concept of ERAS for the treatment of upper urinary tract calculi is safe and reliable, with rapid postoperative recovery, low cost of hospitalization and worthy of clinical promotion.

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A Novel Flexible Ureteroscopy with Intelligent Control of Renal Pelvic Pressure: An Initial Experience of 93 Cases

Abstract: Our patented system is technically feasible, safe, and efficient for treating upper urinary calculi. The advantages include breaking stones effectively and low complication rates because of its automatic control of RPP.

Cited by 57 publications

References 24 publications

A study on the clinical application of a patented perfusion and suctioning platform and ureteral access sheath in the treatment of large ureteral stones below L4 level

A study on the clinical application of a patented perfusion and suctioning platform and ureteral access sheath in the treatment of large ureteral stones below L4 level

Impact of ureteral access sheath on renal stone treatment: Prospective comparative non-randomised outcomes over a 7-year period

Flexible Ureteroscopic Lithotripsy Based on the Concept of Enhanced Recovery After Surgery

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