Flexible Vacuum-assisted Ureteral Access Sheath for Treating Impacted Ureteral Stones.

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2025-01-21 DOI:10.1159/000542944

Yujun Chen, Heng Yang, Haibo Xi, Yue Yu, Wen Deng, Xiaochen Zhou, Gongxian Wang

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引用次数: 0

Abstract

Introduction: To evaluate the feasibility and safety of using the novel flexible vacuum-assisted ureteral access sheath (FV-UAS) in flexible ureteroscopy (F-URS) treatment of impacted non-distal ureteral stones.

Methods: We analyzed data from patients who underwent FV-UAS treatment for impacted non-distal ureteral stones between January 2022 and September 2023. Perioperative parameters were evaluated, including operative time, ureteral injury, and complications. The FV-UAS have a 10 cm passive deflection segment at the distal end of the ureteral access sheath that can bend following the deflection of the F-URS, while also being connected to a vacuum device for aspiration.

Results: A total of 62 consecutive patients (35 females) were included. Mean (range) patient age was 50.0 (29-75) years. Mean (range) largest stone size was 13.8 (9-16) mm. Mean (range) total time was 34.2 (18-46) min. In 57 patients (91.9%), no residual stones were detected in the renal, while 5 patients (8.1%) had residual stones smaller than 4 mm. A 5-tier classification quantified ureteral injury severity at stone impaction sites: grade 0 (n=10); grade 1 (n=47); grade 2 (n=5); grade 3 and 4 (n=0). Nine patients (14.5%) underwent placement of two double-J stent. Two patients (3.2%) developed postoperative fever requiring antibiotics and conservative management. Mean (range) postoperative hospital stay was 1.2 (1-2) day. At the 3-month follow-up, no ureteral strictures had occurred. No additional surgical interventions were necessary during follow-up.

Conclusion: The use of the FV-UAS for the treatment of impacted non-distal ureteral stones is a safe and effective surgical method.

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柔性真空辅助输尿管导管套治疗输尿管梗阻结石。

前言：评价新型柔性真空辅助输尿管通路鞘（FV-UAS）在柔性输尿管镜（F-URS）治疗非远端输尿管梗阻结石中的可行性和安全性。方法：我们分析了2022年1月至2023年9月期间接受FV-UAS治疗的非远端输尿管结石患者的数据。评估围手术期参数，包括手术时间、输尿管损伤和并发症。FV-UAS在输尿管通路鞘的远端有一个10厘米的被动偏转段，可以随着F-URS的偏转而弯曲，同时也连接到真空装置进行抽吸。结果：共纳入62例患者，其中女性35例。患者平均（范围）年龄为50.0岁（29-75岁）。平均（范围）最大的结石尺寸为13.8（9-16）毫米。平均（范围）总时间为34.2（18-46）分钟。57例（91.9%）患者未检出肾结石残留，5例（8.1%）患者肾结石残留小于4 mm。结石嵌塞部位输尿管损伤严重程度的5级分级量化：0级（n=10）；1级（n=47）；2级（n=5）；3级和4级（n=0）。9例患者（14.5%）行2个双j型支架置入。2例患者（3.2%）出现术后发热，需要抗生素和保守治疗。平均（范围）术后住院时间为1.2（1-2）天。随访3个月，无输尿管狭窄发生。随访期间不需要额外的手术干预。结论：FV-UAS治疗非远端输尿管阻生结石是一种安全有效的手术方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.