Comparison of flexible ureteroscopy with flexible and navigable suction ureteral access sheath and mini-percutaneous nephrolithotripsy for the treatment of impacted upper ureteral stones: a retrospective study.
Haiyang Tang, Yulong Che, Zhanpeng Wu, Fangchao Yuan, Jiayu Liu, Jie Li
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引用次数: 0
Abstract
Background and objective: The treatment of impacted upper ureteral stones remains a significant challenge for urologists. Standard treatment protocols often favor Mini-Percutaneous Nephrolithotripsy (Mini-PCNL). It has been supposed to be associated with a higher stone clearance rate and a lower incidence of ureteral stricture compared to Flexible Ureteroscopy (FURS). Recently, FURS with flexible and navigable suction ureteral access sheath (FANS) has emerged as a promising alternative. The aim of this study was to compare the efficacy and safety of the FURS with FANS and Mini-PCNL for treating the impacted upper ureteral stones.
Method: A retrospective study of 80 patients treated with FURS with FANS (Group A, n = 43) or Mini-PCNL (Group B, n = 37) was conducted in our center (from June 2023 to August 2024). Primary outcomes included stone-free rate (SFR), hemoglobin drop, hospital stay, and complications (Clavien-Dindo classification) in 3 months.
Results: Both groups achieved comparable SFR (90.7% vs. 83.78%, P = 0.351). Group A had significantly lower hemoglobin drop (3.65 ± 8.39 vs. 7.89 ± 9.39 g/L, P = 0.036) and shorter hospital stays (1.79 ± 1.08 vs. 3.81 ± 1.37 days, P < 0.001). Complication rates were similar, but Group A had a higher rate of second-stage operation (18.6% vs. 8.1%, P = 0.174) and neither group required reoperation for ureteral stricture or rupture at 3 months post-surgery.
Conclusion: FURS with FANS is a safe and effective alternative to Mini-PCNL for impacted upper ureteral stones larger than 10 mm, offering shorter recovery times and lower bleeding. However, its higher second-stage operation rate necessitates further investigation.
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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