Comparison of flexible ureteroscopic suction techniques: efficacy and safety of flexible and navigable access sheath (FANS) vs. direct in-scope suction (DISS) in the management of 2-3 cm lower pole renal stones.

IF 2 2区医学 Q2 UROLOGY & NEPHROLOGY

Urolithiasis Pub Date : 2025-04-19 DOI:10.1007/s00240-025-01748-7

Ümit Yildirim, Mehmet Uslu, Mehmet Ezer, Çağlayan Erdoğdu, Ramazan Kocaaslan, Kemal Sarica

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引用次数: 0

Abstract

This study compares the efficacy and safety of two techniques for flexible ureteroscopy (FURS) in managing 2-3 cm lower pole renal stones: the use of flexible and navigable access sheath (FANS) versus direct in-scope suction (DISS) without an access sheath. A retrospective analysis of 60 patients undergoing FURS for lower pole renal stones was conducted between March 2023 and January 2025. Group 1 (n = 32) underwent FANS-assisted procedures, while Group 2 (n = 28) underwent sheathless FURS with DISS. Stone-free rates (SFR) were assessed with non-contrast computed tomography (NCCT) after four weeks. Operative time, peri- and postoperative complications, and hospitalization duration were also compared. The mean operative time was significantly shorter in the FANS group (71.8 ± 11.5 min) compared to the DISS group (79.1 ± 11.7 min, p = 0.026). The difference between the SFRs obtained in the FANS group (62.5%) and the DISS group (46.4%) after the first session was not statistically significant (p = 0.162). After the second session, SFRs were also comparable (87.5% vs. 82.1%, p = 0.412) (Residual stones < 4 mm were considered stone-free). Completely stone-free rates (CSFR), defined as the absence of residual fragments after the first session were 43.7% in the FANS group and 32.1% in the DISS group (p = 0.256), while after the second session, these rates increased to 84.3% and 75%, respectively (p = 0.280). Postoperative fever rates (9.3% vs. 10.7%, p = 0.598) and hospitalization duration (2.5 ± 1.3 vs. 2.6 ± 1.4 days, p = 0.819) were similar. Both techniques achieved high overall SFRs for large lower pole stones in a staged manner. However, FANS was associated with a shorter operative time. While DISS eliminates the need for an access sheath, its longer operative time may be a limitation. Larger studies are needed to further evaluate these techniques.

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柔性输尿管镜吸引技术的比较：柔性可导航通路鞘（FANS）与直接镜内吸引（DISS）治疗2-3 cm下极肾结石的疗效和安全性。

本研究比较了柔性输尿管镜（FURS）治疗2-3厘米下极肾结石的两种技术的有效性和安全性：使用柔性可导航通路鞘（FANS）与不使用通路鞘的直接镜内吸引（DISS）。对2023年3月至2025年1月间60例因下极肾结石接受FURS治疗的患者进行回顾性分析。组1 （n = 32）行fans辅助手术，组2 （n = 28）行无鞘FURS + DISS。四周后用非对比计算机断层扫描（NCCT）评估无结石率（SFR）。比较两组手术时间、围术后并发症及住院时间。fan组的平均手术时间（71.8±11.5 min）明显短于DISS组（79.1±11.7 min, p = 0.026）。第一次治疗后，FANS组（62.5%）和DISS组（46.4%）的SFRs差异无统计学意义（p = 0.162）。在第二次治疗后，SFRs也具有可比性（87.5% vs. 82.1%, p = 0.412）

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

Urolithiasis UROLOGY & NEPHROLOGY-

CiteScore

4.50

自引率

6.50%

发文量

期刊介绍： Official Journal of the International Urolithiasis Society The journal aims to publish original articles in the fields of clinical and experimental investigation only within the sphere of urolithiasis and its related areas of research. The journal covers all aspects of urolithiasis research including the diagnosis, epidemiology, pathogenesis, genetics, clinical biochemistry, open and non-invasive surgical intervention, nephrological investigation, chemistry and prophylaxis of the disorder. The Editor welcomes contributions on topics of interest to urologists, nephrologists, radiologists, clinical biochemists, epidemiologists, nutritionists, basic scientists and nurses working in that field. Contributions may be submitted as full-length articles or as rapid communications in the form of Letters to the Editor. Articles should be original and should contain important new findings from carefully conducted studies designed to produce statistically significant data. Please note that we no longer publish articles classified as Case Reports. Editorials and review articles may be published by invitation from the Editorial Board. All submissions are peer-reviewed. Through an electronic system for the submission and review of manuscripts, the Editor and Associate Editors aim to make publication accessible as quickly as possible to a large number of readers throughout the world.