Assessment of Outcomes & Anatomical Changes in the Upper Urinary Tract following Flexible Ureteroscopy with a Flexible and Navigable Suction Ureteral Access Sheath (FANS): 3-Month Results from a Multicenter Study.
Khi Yung Fong, Steffi Kar Kei Yuen, Bhaskar Kumar Somani, Vigen Malkhasyan, Yiloren Tanidir, Satyendra Persaud, Albert El Hajj, Chu-Ann Chai, Tzevat Tefik, Karl Tan, Mohamed Elshazly, Deepak Ragoori, Mehmet Ilker Gokce, Boyke Soebhali, Saeed Bin Hamri, Nariman Gadzhiev, Ben Turney, Olivier Traxer, Daniele Castellani, Vineet Gauhar
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Abstract
Objectives: To study the long-term outcomes of the flexible and navigable suction ureteral access sheath (FANS) in flexible ureteroscopy (FURS). FANS has well-established efficiency and 30-day perioperative safety; however, its influence on pelvicalyceal and ureteric anatomy remains to be investigated.
Methods: This was a prospective study of patients with normal renal anatomy who underwent FURS with FANS for renal stones from April 2023 to August 2024 in 16 centers worldwide. 30-day postoperative stone free rate and delayed complications after 3 months were analyzed with a non-contrast CT scan and contrasted CT urogram respectively. The primary aim was to report if FANS could potentially cause pelviureteric junction, pelvicalyceal or ureteric complications.
Results: 310 patients were analyzed. Median age was 51; median stone volume was 1584 mm3. Disposable scopes were used in 58.1%. Predominant laser energies were Thulium fiber laser (56.1%) followed by Thulium-YAG laser (20.6%). Median laser time was 14min, median ureteroscopy time was 30min, and median total operation time was 45min. Ureteric injury occurred in 11 patients (3.5%), of which 10 were Traxer-Thomas Grade 1. On 30-day NCCT, 63.5% of patients had zero residual fragments; overall stone-free status was seen in 95.1%. 30-day reintervention rate was 4.2% (13 cases). 3-month CT urogram showed ureteric stenosis in only 1 patient (0.3%) who was managed by dilatation and stenting. No other anatomical anomalies were recorded.
Conclusions: The extremely low rates of 3-month adverse outcomes, high immediate SFR, and low 30-day reintervention rates further strengthen the evidence for safety and effectiveness of FANS.
期刊介绍：
Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology
The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.
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