Impact of suction ureteral access sheath in ureteroscopy/retrograde intrarenal surgery: a systematic review and meta-analysis.

IF 1.9 3区医学 Q4 ANDROLOGY

Translational andrology and urology Pub Date : 2025-05-30 Epub Date: 2025-05-27 DOI:10.21037/tau-2025-138

Sotaro Kayano, Akihiro Matsukawa, Ekaterina Laukhtina, Yuji Yata, Keiichiro Miyajima, Masaya Murakami, Tatsuya Shimomura, Steffi Kar Kei Yuen, Shahrokh F Shariat, Takahiro Kimura, Takafumi Yanagisawa

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引用次数: 0

Abstract

Background: Advances in technology have led to the introduction of the suction ureteral access sheaths (SUASs) in ureteroscopy (URS) and retrograde intrarenal surgery (RIRS), with their clinical benefits becoming widely acknowledged. We aimed to evaluate the efficacy and safety of using SUASs during URS and RIRS.

Methods: A systematic search was conducted in April 2024 across the MEDLINE, Scopus, and Web of Science databases. Our focus was on studies investigating the use of SUASs during URS/RIRS for urinary stones. To compare the stone-free rate (SFR) and perioperative outcomes between URS/RIRS procedures with and without SUASs, standard pairwise meta-analyses were conducted. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were employed utilizing a random-effects model (PROSPERO: CRD42024538956).

Results: Seven studies (n=1,746) were identified. The use of SUASs significantly improved immediate SFR compared to non-SUAS group (RR: 1.23; 95% CI: 1.02 to 1.47; P=0.03), while no significant difference was observed in SFR at one month follow-up. The use of SUASs significantly reduced operation time (MD: -7.98 minutes; 95% CI: -13.46 to -2.50; P=0.004) and overall complication rate (RR: 0.49; 95% CI: 0.34 to 0.71; P<0.001).

Conclusions: Our meta-analyses indicate that the use of SUASs during URS/RIRS significantly improves immediate SFR and offers better perioperative outcomes compared to no use of SUASs. To establish SUASs as standard of care, well-designed randomized controlled trials are needed.

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输尿管镜检查/逆行肾内手术中输尿管吸引鞘的影响：一项系统回顾和荟萃分析。

背景：随着技术的进步，在输尿管镜检查（URS）和逆行肾内手术（RIRS）中引入了吸力输尿管导管鞘（SUASs），其临床效益得到了广泛认可。我们的目的是评估在URS和RIRS期间使用SUASs的有效性和安全性。方法：于2024年4月对MEDLINE、Scopus和Web of Science数据库进行系统检索。我们的重点是研究尿路结石在URS/RIRS期间使用SUASs的情况。为了比较有无SUASs的URS/RIRS手术的无结石率（SFR）和围手术期结果，进行了标准的两两荟萃分析。采用随机效应模型（PROSPERO: CRD42024538956），采用95%置信区间（ci）的风险比（rr）和平均差异（MDs）。结果：7项研究（n=1,746）被确定。与非suas组相比，使用suas可显著改善即时SFR (RR: 1.23；95% CI: 1.02 ~ 1.47；P=0.03)，而1个月随访时SFR无显著差异。使用SUASs可显著缩短手术时间(MD: -7.98分钟；95% CI: -13.46 ~ -2.50；P=0.004)和总并发症发生率(RR: 0.49；95% CI: 0.34 ~ 0.71；结论：我们的荟萃分析表明，与不使用SUASs相比，在URS/RIRS期间使用SUASs可显著改善即时SFR，并提供更好的围手术期预后。为了将SUASs确立为治疗标准，需要进行精心设计的随机对照试验。

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

Translational andrology and urology Medicine-Urology

CiteScore

4.10

自引率

5.00%

发文量

期刊介绍： ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.