The use of 14/16Fr ureter access sheath for safe and effective management of large upper ureteral calculi

Tsaturyan, Arman; Kalogeropoulos, George; Lattarulo, Marco; Adamou, Constantinos; Pagonis, Konstantinos; Peteinaris, Angelis; Liourdi, Despoina; Vrettos, Theofanis; Liatsikos, Evangelos; Kallidonis, Panagiotis

doi:10.1007/s00345-022-03949-w

Cited by 7 publications

(4 citation statements)

References 30 publications

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“…With the development of stone retrieval devices and miniaturized flexible ureteroscopes, RIRS is more widely used for treating renal calculi, even for high burden stones [ 6 , 7 ]. The application of ureteral access sheath (UAS) in RIRS can improve surgical vision [ 8 ], reduce intrarenal pressure (IRP) [ 8 , 9 ], and decrease postoperative infectious complications [ 10 ]. Several reports have demonstrated the superiority of suctioning UAS, including shorter operation time, higher SFR and lower incidence of infectious complications compared with traditional ureteral access sheath (T-UAS) [ 11 – 13 ], but none of these suctioning UAS can reach the renal calyces.…”

Section: Introductionmentioning

confidence: 99%

Comparison of traditional and novel tip-flexible suctioning ureteral access sheath combined with flexible ureteroscope to treat unilateral renal calculi

Zhang,

Xie,

et al. 2023

World J Urol

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Objectives To compare the safety and efficacy of novel tip-flexible suctioning ureteral access sheath (NTFS-UAS) and traditional ureteral access sheath (T-UAS) combined with flexible ureteroscope for treating unilateral renal calculi. Materials and methods The clinical data of 214 patients with unilateral renal calculi treated by NTFS-UAS (n = 102) and T-UAS (n = 112) combined with flexible ureteroscope from August 2021 to April 2022 were analyzed retrospectively. Demographic characteristics, stone-related parameters, operative time, stone-free rates (SFR), hospitalization time and complication rate (CR) were analyzed. Result No significant difference was observed between the two groups in terms of demographic characteristics, stone-related parameters, intraoperative CR, and hospitalization time. The operative time of NTFS-UAS group was significantly shorter than T-UAS group (55.25 ± 11.42 min vs. 59.36 ± 15.59 min; P = 0.028). The NTFS-UAS group obtained significantly higher SFR on 1 day postoperatively (86.3% vs. 75.0%; P = 0.038), and higher SFR on 30 days postoperatively than T-UAS group (91.2% vs. 81.3%; P = 0.037). The hemoglobin loss of NTFS-UAS group (− 0.54 ± 0.69 g/dl) was significantly lower than T-UAS group (− 0.83 ± 0.66 g/dl; P = 0.002). There was a significantly lower incidence of overall CR (11.8% vs. 22.3%; P = 0.041), and infectious CR (8.8% vs. 18.8%; P = 0.037) in the NTFS-UAS group. Conclusion Compared to T-UAS combined with flexible ureteroscope for treating unilateral renal calculi, NTFS-UAS had superiority in higher SFR on 1 day and 30 days postoperatively. Shorter operation time, lower hemoglobin loss, lower incidences of overall and infectious CR were observed in NTFS-UAS group. Registration number and date ChiCTR2300070210; April 5, 2023.

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Section: Introductionmentioning

confidence: 99%

Comparison of traditional and novel tip-flexible suctioning ureteral access sheath combined with flexible ureteroscope to treat unilateral renal calculi

Zhang,

Xie,

et al. 2023

World J Urol

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“…However, the diameter of 12Fr UAS is too thick to cause about 46.5% ureteral injury and 13.3% of them involve the muscle layer [8]. The smaller diameter of UAS likely reduces the possibility of ureteral injury [9,10], however in the meanwhile, it will result in higher RESD, which raises the probability of complications from high IPP [11].…”

Section: Introductionmentioning

confidence: 99%

Outcome of combining 7.5Fr disposable electronic flexible ureteroscope with 10Fr ureteral access sheath in the treatment of renal stones < 2cm: initial experience

Song

Cheng

Xie

et al. 2023

Preprint

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Purpose: To evaluate the effectiveness and safety of combining 7.5Fr flexible ureteroscope with 10Fr ureteral access sheath performed in patients with renal calculi under 2cm. Materials and methods: We prospectively involved 10 patients with renal calculi < 2cm who underwent holmium laser lithotripsy using the combination of 7.5Fr flexible ureteroscope and a 10Fr ureteral access sheath without double-J stents pre-reserved. The patients’ profiles, including preoperative, operative information, and postoperative complications, were recorded. Results: The success rate of sheath placement was 100% with the operation time of 55.0 ± 20.0 min, while the lithotripsy time of 150.4 ± 199.0 s. Due to the grade-1 injury of ureter, the double-J stent was retained in two cases for a month. Moreover, the duration of stent-keeping was 18.3 ± 20.13 hours, the hospitalization duration after operation was 45.6 ± 15.5 h, and the pain score after 24 hours postoperatively was 4.3 ± 3.5, respectively. Hemoglobin decreased by 5.0 ± 9.2 g/L and creatinine increased by 1.9 ± 6.6 μmol/L postoperatively, and none of the patients suffered from fever or hemorrhage. The SFR was 90.0% in a month after surgery. In terms of the symptom score of stents, overactive bladder symptom score was 1.7 ± 1.5, international prostate symptom score of 3.3 ± 2.8, and quality of life of 1.3 ± 1.7. Conclusion: Combining 7.5Fr flexible ureteroscope with 10Fr ureteral access sheath is recommended as a safe option for treating renal calculi < 2cm with high rate of sheath placement and lower rate of complication.

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“…Retrograde intracranial surgery (RIRS) is a treatment option for renal or proximal ureteral stones [1]. Ureteral access sheaths (UAS) increase visibility, reduce operating time, and allow multiple reentries to the ureter and are widely used in RIRS [2]. However, failure rates of ureteroscopy due to a difficult impassable ureter range from 8% to 10%, and approximately 22% of patients fail to insert a standard UAS [3].…”

Section: Introductionmentioning

confidence: 99%

Identification of the Risk Factors for the Failure of Ureteral Access Sheath Placement

Liu

et al. 2022

International Journal of Clinical Practice

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Purpose. Insertion of a ureteral access sheath (UAS) may fail in some patients in retrograde intrarenal surgery (RIRS), and this study aimed to seek preoperative risk factors for the failure of 12/14F UAS placement. Methods. We retrospectively analyzed 260 consecutive patients who underwent RIRS between May 2020 and March 2022 at our institution. Data on patient and stone characteristics and several computed tomography (CT)-based measurements were collected and compared between the success and failure UAS placement groups. Results. Twenty-nine (11.2%) patients failed to insert the UAS. Age, gender, height, weight, stone side, stone location, length of history, and computed tomography (CT)-based parameters were not significant differences between the two groups. Univariate logistic regression analyses showed sex (female/male) (odds ratio: 0.287 and 95% CI [0.107, 0.722], p = 0.013 ), length of history 15–31 days (odds ratio: 0.315 and 95% CI [0.102, 0.974], p = 0.045 ), length of history >31 days (odds ratio: 0.202 and 95% CI [0.051, 0.805], p = 0.023 ), and diameter of the ipsilateral common iliac artery (odds ratio: 1.285 and 95% CI [1.018, 1.623], p = 0.035 ) were associated with UAS placement. Conclusion. Our study indicated that males, the short length of history, and the short diameter of the ipsilateral common iliac artery were the risk factors for the failure of UAS placement.

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The use of 14/16Fr ureter access sheath for safe and effective management of large upper ureteral calculi

Cited by 7 publications

References 30 publications

Comparison of traditional and novel tip-flexible suctioning ureteral access sheath combined with flexible ureteroscope to treat unilateral renal calculi

Comparison of traditional and novel tip-flexible suctioning ureteral access sheath combined with flexible ureteroscope to treat unilateral renal calculi

Outcome of combining 7.5Fr disposable electronic flexible ureteroscope with 10Fr ureteral access sheath in the treatment of renal stones < 2cm: initial experience

Identification of the Risk Factors for the Failure of Ureteral Access Sheath Placement

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The use of 14/16Fr ureter access sheath for safe and effective management of large upper ureteral calculi

Cited by 7 publications

References 30 publications

Comparison of traditional and novel tip-flexible suctioning ureteral access sheath combined with flexible ureteroscope to treat unilateral renal calculi

Comparison of traditional and novel tip-flexible suctioning ureteral access sheath combined with flexible ureteroscope to treat unilateral renal calculi

Outcome of combining 7.5Fr disposable electronic flexible ureteroscope with 10Fr ureteral access sheath in the treatment of renal stones &lt; 2cm: initial experience

Identification of the Risk Factors for the Failure of Ureteral Access Sheath Placement

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Outcome of combining 7.5Fr disposable electronic flexible ureteroscope with 10Fr ureteral access sheath in the treatment of renal stones < 2cm: initial experience