Comparison of suctioning and traditional ureteral access sheath during flexible ureteroscopy in the treatment of renal stones

Zhu, Zewu; Yang, Li; Chen, Zhiyong; Chen, Hequn

doi:10.1007/s00345-018-2455-8

Cited by 57 publications

(42 citation statements)

References 20 publications

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“…In our study, the SFR of 1 day after the operation of the ST-URS group was significantly higher than the F-URS group (63.71 vs. 34.62%, P < 0.0001), but the SFR of 1 month after the operation was comparable in the two groups (87.10 vs. 81.41%, P = 0.198). Consistent with our results, the study of Zewu Zhu also shows that the suctioning UAS group had a significantly higher SFR of 1 day postoperatively and a significantly shorter operative time in the treatment of renal stones ( 35 ). Compared to other studies of patients with similar stone burdens, our SFR result of 1 day postoperatively was superior to that reported in studies in which F-URS was used ( 36 , 37 ).…”

Section: Discussionsupporting

confidence: 90%

“…In our study, the incidence of infectious complications of the ST-URS group (7.26%) was lower than the F-URS group (10.26%). Zhu et al also found the incidence of infectious complications was 7.90% in the suctioning UAS group vs. 22.4% in the traditional UAS group and both higher than our results ( 35 ). This may be because the average stone size is larger in their study (18.2 and 17.4 vs. 13.7 and 13.5 mm).…”

Section: Discussioncontrasting

confidence: 78%

“…This may be related to the small sample size in this study and the results need to be confirmed by a large sample study in the future. Our study combined with these published results showed that the ST-URS with negative pressure suction device has the advantages of high lithotripsy efficacy, fewer complications, more safety, and treating the upper ureteral calculi effectively (33,35,39,40). Ito et al reported that the CT value of stones is significantly related to the efficiency of lithotripsy (42).…”

Section: Discussionsupporting

confidence: 63%

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Comparison of the Efficacy of ShuoTong Ureteroscopy and Simple Flexible Ureteroscopy in the Treatment of Unilateral Upper Ureteral Calculi

et al. 2021

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Background: ShuoTong ureteroscopy (Sotn-ureteroscopy, ST-URS), a new lithotripsy operation method developed on the basis of ureteroscopy, is widely used to treat ureteral stones in China. Its composition includes rigid ureteral access sheath, standard mirror, lithotripsy mirror, and ShuoTong perfusion aspirator (ST-APM). Here, we compared the efficacy and safety of the ST-URS and the flexible ureteroscope (F-URS) holmium laser lithotripsy in the treatment of unilateral upper ureteral calculi.Methods: Retrospective analysis was conducted on the clinical data of 280 patients who met the inclusion 1) urinary tract CT was diagnosed with unilateral single upper ureteral calculi above the L4 lumbar spine; 2) patient age was from 18 to 80 years old; 3) patients were informed and consented to this study; and 4) patients were approved by the hospital ethics committee (proof number: KY-2019-020) and the exclusion criteria for unilateral upper ureteral calculi in the First Affiliated Hospital of Xiamen University from January 2018 to November 2020, and they were divided into the ST-URS group and the flexible ureteroscopy (F-URS) group.Results: The stone-free rate of 1 day after operation of the ST-URS group was significantly higher than the F-URS group (63.71 vs. 34.62%, P < 0.0001). The operative time (38.45 vs. 46.18 min, P = 0.005) and hospitalization cost (27,203 vs. 33,220 Yuan, P < 0.0001) of the ST-URS group were significantly lower than the F-URS group. There were no significant differences in the success rate of ureteral access sheath placement, operative blood loss, stone-free rate of 1 month after operation, postoperative complications, postoperative hospital stay, and postoperative visual analog scale (VAS) pain score between the two groups (P > 0.05). In subgroups of a diameter of calculi ≥ 1.5 cm, calculi CT numerical value ≥ 1,000 Hounsfield unit and the preoperative hydronephrosis range ≥ 3.0 cm, ST-URS shows more advantages in the operative time, stone-free rate of 1 day after the operation, the hospitalization cost, and the incidence of postoperative complications.Conclusion: In unilateral upper ureteral stones treated with a holmium laser, compared with the simple F-URS, the ST-URS has a shorter operative time, lower hospitalization cost, and a higher stone-free rate of 1 day after the operation, suggesting that the ST-URS could be more widely applied in clinics.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 78%

Section: Discussionsupporting

confidence: 63%

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Comparison of the Efficacy of ShuoTong Ureteroscopy and Simple Flexible Ureteroscopy in the Treatment of Unilateral Upper Ureteral Calculi

et al. 2021

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“…e application of a ureteral access sheath (UAS) can accelerate the drainage of perfusion fluid, preventing high renal pelvic pressure (RPP) and postoperative infectious complications [5][6][7]; however, this pressure can only be decreased to a certain extent, especially for a ureteral sheath of a smaller diameter. Herein, the application of suctioning UAS is a good means of attaining a low RPP.…”

Section: Introductionmentioning

confidence: 99%

Application of Suctioning Ureteral Access Sheath during Flexible Ureteroscopy for Renal Stones Decreases the Risk of Postoperative Systemic Inflammatory Response Syndrome

Qian

Liu

Hong

et al. 2022

International Journal of Clinical Practice

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Purpose. To clarify the efficiency and outcomes of suctioning ureteral access sheath (UAS) during flexible ureteroscopic lithotripsy (fURL) for the management of renal stones. Methods. Between January 2017 and January 2019, a total of 444 patients with renal stones undergoing fURL were divided into suctioning UAS and nonsuctioning UAS groups. The outcomes of patients in both groups were compared using a matched-pair analysis (1 : 1 scenario). Furthermore, a directed acyclic graph (DAG) was drawn to guide the multivariate logistic regression model and analyze the protective effect of suctioning UAS on the incidence of postoperative systemic inflammatory response syndrome (SIRS). Results. Before propensity score matching, significant differences were observed between the two groups in blood white cell counts, urine white cell counts, preoperative fever, preoperative indwelling stents, and laterality ( P < 0.05 ). Eighty-one patients in the suctioning UAS group were successfully matched with 81 patients in the nonsuctioning group. The stone-free rate (SFR) on postoperative day 1 after fURL in the suctioning group was higher than that in the nonsuctioning group (86.4% vs. 71.6%; P = 0.034 ), whereas it was comparable between the two groups 1 month after the surgery (88.9% vs. 82.7%; P = 0.368 ). The incidence of postoperative fever or SIRS was lower in the suctioning group (fever: 3.70% vs. 14.8%; P = 0.030 ; SIRS: 1.23% vs. 12.3%; P = 0.012 ). However, the operative duration was similar in both groups (mean (SD)) (72.9 (28.1) min vs. 80.0 (29.5) min; P = 0.121 ). The result of the multivariate logistic regression model guided by DAG revealed that the application of nonsuctioning UAS (odds ratio: 5.28 [1.38–35.07], P = 0.034 ) during fURL was associated with postoperative SIRS. Conclusions. The application of suctioning UAS during fURL was associated with higher SFR on day 1 after surgery and a lower incidence of postoperative fever or SIRS.

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“…Due to the continuous water circulation that can be formed in the front of the ureteroscope during operation, the pressure gradient between the proximal and distal stone ends is small [12] , the impact force on the stones is therefore small and the stones are not easy to move and escape to the kidneys causing postoperative residual stones [13] . During the operation, 275µm holmium laser ber was used to pulverize the stone in situ in a "worm eaten" fashion.…”

Section: Discussionmentioning

confidence: 99%

A Study on the Clinical Application of a New Type of Integrated Suctioning Semi-Rigid Ureteroscopic Lithotripsy for Ureteral Calculi

Fan

Liao²,

Luo

et al. 2022

Preprint

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OBJECTIVE: To explore the effect and clinical value of a new type of integrated suctioning semi-rigid ureteroscopic lithotripsy for treating ureteral calculi. METHODS: Retrospective analysis the clinic data of 180 patients who underwent surgery for ureteral calculi from May 2019 to October 2020 in our department, which was divided into three groups, 60 cases each. Group A used traditional semi-rigid ureteroscopic lithotripsy, group B used a suctioning semi-rigid ureteroscopic lithotripsy with a sheath being connected to a vacuum device; group C used a new type of suctioning integrated rigid ureteroscopic lithotripsy with a novelly designed ureteroscope. RESULTS: One hundred and sixty-four cases of ureteroscopic lithotripsy were completed in one stage, and the remaining 16 cases were converted to other surgical methods due to difficulty in placing a suctioning sheath or entering the ureteroscope due to ureteral stricture. Compared with group A, group C had a higher rate of stone stone-clearance rate at 30 days after surgery, a shorter operation time and fewer hospitalization days (P<0.05); Compared with group B, group C had a had a higher one-stage operation success rate, a shorter operation time and fewer hospitalization days (P<0.05). CONCLUSIONS: Compared with the other two types, the new type suctioning integrated semi-rigid ureteroscopic lithotripsy has certain advantages including reduced operation time and length of hospital stay, and higher level of minimally invasiveness for upper urinary calculi.

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Comparison of suctioning and traditional ureteral access sheath during flexible ureteroscopy in the treatment of renal stones

Abstract: Compared to traditional UAS during FURS for treating renal stones, suctioning UAS had the advantages of higher SFR 1 day postoperatively, a lower incidence of infectious complications and a shorter operative time. Further well-designed studies are required to confirm the results.

Cited by 57 publications

References 20 publications

Comparison of the Efficacy of ShuoTong Ureteroscopy and Simple Flexible Ureteroscopy in the Treatment of Unilateral Upper Ureteral Calculi

Comparison of the Efficacy of ShuoTong Ureteroscopy and Simple Flexible Ureteroscopy in the Treatment of Unilateral Upper Ureteral Calculi

Application of Suctioning Ureteral Access Sheath during Flexible Ureteroscopy for Renal Stones Decreases the Risk of Postoperative Systemic Inflammatory Response Syndrome

A Study on the Clinical Application of a New Type of Integrated Suctioning Semi-Rigid Ureteroscopic Lithotripsy for Ureteral Calculi

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