Is flexible navigable suction ureteral access sheath (FANS) safer and more efficient than conventional sheaths? Italian multicentric experience.

IF 2.8 2区医学 Q2 UROLOGY & NEPHROLOGY

World Journal of Urology Pub Date : 2025-03-06 DOI:10.1007/s00345-025-05520-9

Loris Cacciatore, Antonio Minore, Lilla Bonanno, Pierangelo Contessa, Francesco Esperto, Antonio Rosario Iannello, Rocco Papalia

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引用次数: 0

Abstract

Background and objective: The flexible and navigable suction ureteral access sheath (FANS) with continuous flow lithotripsy may improve stone-free rates (SFR) in ureterorenolithotripsy procedures, reducing operative time and the need for fragment extraction. This study aimed to compare the safety and efficacy of FANS versus conventional sheaths in patients undergoing retrograde intrarenal surgery (RIRS) for renal stones.

Methods: From January to September 2024, patients undergoing RIRS with high-power pulsed lasers (60 W Ho:YAG or 100 W pTm:YAG) were randomized to receive either a conventional sheath (Group 1) or FANS (Group 2). Data on baseline characteristics, operative details, and complications were collected. SFR, defined as the absence of fragments > 3 mm, was assessed with non-contrast CT scans one-month post-surgery. Statistical significance was set at p < 0.05.

Results: A total of 132 patients were enrolled (70 with conventional sheath, 62 with FANS). The FANS group had shorter operative times (55.25 vs. 61.36 min, p = 0.028), while laser time was similar between groups. Postoperative complications were lower in the FANS group. At one month, the FANS group had a higher SFR (95% vs. 67%, p < 0.005) and fewer re-interventions (p = 0.02).

Conclusions: FANS significantly improves SFR without increasing postoperative complications postoperative complications or negatively affecting recovery, offering a promising alternative to conventional sheaths in ureterorenolithotripsy procedures. FANS improves kidney stone surgery outcomes, providing better stone removal, fewer complications, and faster recovery compared to the standard tool.

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柔性导航式输尿管吸入鞘（FANS）是否比传统的输尿管鞘更安全、更有效？意大利多中心体验。

背景与目的：柔性、可导航的吸力输尿管通路鞘（FANS）配合连续流碎石术可提高输尿管结石碎石术中的结石清除率（SFR），减少手术时间和碎片取出的需要。本研究旨在比较fan与传统鞘在肾结石逆行肾内手术（RIRS）患者中的安全性和有效性。方法：从2024年1月至9月，接受高功率脉冲激光（60 W Ho:YAG或100 W pTm:YAG） RIRS的患者随机接受常规鞘套（1组）或FANS（2组）。收集基线特征、手术细节和并发症的数据。术后1个月通过非对比CT扫描评估SFR，定义为无碎片bbb30 mm。结果：共纳入132例患者（70例采用常规护套，62例采用FANS）。fan组手术时间较短（55.25 vs. 61.36 min, p = 0.028），两组间激光时间相似。fan组术后并发症较低。1个月时，FANS组有更高的SFR （95% vs. 67%）。结论：FANS可显著改善SFR，而不会增加术后并发症或对恢复产生负面影响，为输尿管结石碎石术中常规鞘提供了一个有希望的替代方案。与标准工具相比，FANS可以改善肾结石手术结果，提供更好的结石清除，更少的并发症和更快的恢复。

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

World Journal of Urology 医学-泌尿学与肾脏学

CiteScore

6.80

自引率

8.80%

发文量

317

审稿时长

4-8 weeks

期刊介绍： The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.