Vineet Gauhar, Olivier Traxer, Daniele Castellani, Khi Y Fong, Saeed Bin Hamri, Mehmet I Gökce, Nariman Gadzhiev, Mariela Corrales, Vigen Malkhasyan, Deepak Ragoori, Boyke Soebhali, Karl Tan, Chu A Chai, Azimdjon N Tursunkulov, Yiloren Tanidir, Satyendra Persaud, Mohamed Elshazly, Wissam Kamal, Tzevat Tefik, Anil Shrestha, Ben H Chew, Mohamed A Lakmichi, Andrea B Galosi, Heng C Tiong, Christian Seitz, Bhaskar K Somani
{"title":"使用灵活、可导航的抽吸输尿管入路鞘进行逆行肾内手术治疗单发肾结石后 24 小时的手术效果。欧洲泌尿外科协会泌尿系结石分会的一项前瞻性全球多中心研究。","authors":"Vineet Gauhar, Olivier Traxer, Daniele Castellani, Khi Y Fong, Saeed Bin Hamri, Mehmet I Gökce, Nariman Gadzhiev, Mariela Corrales, Vigen Malkhasyan, Deepak Ragoori, Boyke Soebhali, Karl Tan, Chu A Chai, Azimdjon N Tursunkulov, Yiloren Tanidir, Satyendra Persaud, Mohamed Elshazly, Wissam Kamal, Tzevat Tefik, Anil Shrestha, Ben H Chew, Mohamed A Lakmichi, Andrea B Galosi, Heng C Tiong, Christian Seitz, Bhaskar K Somani","doi":"10.23736/S2724-6051.24.05961-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Suction techniques showed potential to improve outcomes of retrograde intra-renal surgery (RIRS). We assessed the 24-hour stone-free rate (SFR) and complications after RIRS using flexible and navigable suction ureteral access sheaths (FANS-UAS).</p><p><strong>Methods: </strong>Sixteen centers prospectively contributed to data (August 2023-October 2023). Inclusion criteria: age ≥18 years, single renal stone, pre and 24-hour post-RIRS CT scan. Exclusion criteria were: ureteral stone, anomalous kidney, multiple stones. SFR was divided into: 1) grade A - no fragments; 2) grade B - fragments ≤2 mm; 3) grade C - fragments 2.1-4 mm; and 4) grade D - fragments >4 mm. A multivariable logistic regression analysis model was performed to assess factors associated with the odds of having grade A stone-free status. Data are expressed as median (interquartile range), absolute numbers and frequencies, odds ratio (OR), and 95% confidence interval (CI).</p><p><strong>Results: </strong>One hundred forty-two patients with a median age of 52 years (40-61) were enrolled. 61.3% were males. Median stone volume was 1165 mm<sup>3</sup> (656-1936). Median operative time was 48.5 (36.25-71.75) min. Transient fever (37°C-37.5°C) occurred in 10 (7%) patients. No sepsis case occurred. 96.5% of patients were stone-free (Grade A+B). Grade A SFR was 52.8%. All patients were discharged within 48 hours. Bone window (OR 3.156 95% CI 1.177-9.130, P=0.027) was the only factor significantly associated with higher odds of 100% SFR, while stone volume (OR 0.999, 95% CI 0.999-1.000, P=0.007) was significantly associated with lower odds.</p><p><strong>Conclusions: </strong>Imaging and clinical evidence demonstrate excellent perioperative outcomes just 24 hours post RIRS with FANS-UAS. The technique demonstrates a good safety profile, ability for immediate high SFR, and a low rate of infective complications.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"76 5","pages":"625-634"},"PeriodicalIF":4.9000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Operative outcomes 24 hours after retrograde intrarenal surgery for solitary renal calculi using a flexible and navigable suction ureteral access sheath. A prospective global multicenter study by the European Association of Urology Section on Urolithiasis.\",\"authors\":\"Vineet Gauhar, Olivier Traxer, Daniele Castellani, Khi Y Fong, Saeed Bin Hamri, Mehmet I Gökce, Nariman Gadzhiev, Mariela Corrales, Vigen Malkhasyan, Deepak Ragoori, Boyke Soebhali, Karl Tan, Chu A Chai, Azimdjon N Tursunkulov, Yiloren Tanidir, Satyendra Persaud, Mohamed Elshazly, Wissam Kamal, Tzevat Tefik, Anil Shrestha, Ben H Chew, Mohamed A Lakmichi, Andrea B Galosi, Heng C Tiong, Christian Seitz, Bhaskar K Somani\",\"doi\":\"10.23736/S2724-6051.24.05961-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Suction techniques showed potential to improve outcomes of retrograde intra-renal surgery (RIRS). We assessed the 24-hour stone-free rate (SFR) and complications after RIRS using flexible and navigable suction ureteral access sheaths (FANS-UAS).</p><p><strong>Methods: </strong>Sixteen centers prospectively contributed to data (August 2023-October 2023). Inclusion criteria: age ≥18 years, single renal stone, pre and 24-hour post-RIRS CT scan. Exclusion criteria were: ureteral stone, anomalous kidney, multiple stones. SFR was divided into: 1) grade A - no fragments; 2) grade B - fragments ≤2 mm; 3) grade C - fragments 2.1-4 mm; and 4) grade D - fragments >4 mm. A multivariable logistic regression analysis model was performed to assess factors associated with the odds of having grade A stone-free status. Data are expressed as median (interquartile range), absolute numbers and frequencies, odds ratio (OR), and 95% confidence interval (CI).</p><p><strong>Results: </strong>One hundred forty-two patients with a median age of 52 years (40-61) were enrolled. 61.3% were males. Median stone volume was 1165 mm<sup>3</sup> (656-1936). Median operative time was 48.5 (36.25-71.75) min. Transient fever (37°C-37.5°C) occurred in 10 (7%) patients. No sepsis case occurred. 96.5% of patients were stone-free (Grade A+B). Grade A SFR was 52.8%. All patients were discharged within 48 hours. Bone window (OR 3.156 95% CI 1.177-9.130, P=0.027) was the only factor significantly associated with higher odds of 100% SFR, while stone volume (OR 0.999, 95% CI 0.999-1.000, P=0.007) was significantly associated with lower odds.</p><p><strong>Conclusions: </strong>Imaging and clinical evidence demonstrate excellent perioperative outcomes just 24 hours post RIRS with FANS-UAS. The technique demonstrates a good safety profile, ability for immediate high SFR, and a low rate of infective complications.</p>\",\"PeriodicalId\":53228,\"journal\":{\"name\":\"Minerva Urology and Nephrology\",\"volume\":\"76 5\",\"pages\":\"625-634\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Minerva Urology and Nephrology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.23736/S2724-6051.24.05961-5\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Minerva Urology and Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23736/S2724-6051.24.05961-5","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Operative outcomes 24 hours after retrograde intrarenal surgery for solitary renal calculi using a flexible and navigable suction ureteral access sheath. A prospective global multicenter study by the European Association of Urology Section on Urolithiasis.
Background: Suction techniques showed potential to improve outcomes of retrograde intra-renal surgery (RIRS). We assessed the 24-hour stone-free rate (SFR) and complications after RIRS using flexible and navigable suction ureteral access sheaths (FANS-UAS).
Methods: Sixteen centers prospectively contributed to data (August 2023-October 2023). Inclusion criteria: age ≥18 years, single renal stone, pre and 24-hour post-RIRS CT scan. Exclusion criteria were: ureteral stone, anomalous kidney, multiple stones. SFR was divided into: 1) grade A - no fragments; 2) grade B - fragments ≤2 mm; 3) grade C - fragments 2.1-4 mm; and 4) grade D - fragments >4 mm. A multivariable logistic regression analysis model was performed to assess factors associated with the odds of having grade A stone-free status. Data are expressed as median (interquartile range), absolute numbers and frequencies, odds ratio (OR), and 95% confidence interval (CI).
Results: One hundred forty-two patients with a median age of 52 years (40-61) were enrolled. 61.3% were males. Median stone volume was 1165 mm3 (656-1936). Median operative time was 48.5 (36.25-71.75) min. Transient fever (37°C-37.5°C) occurred in 10 (7%) patients. No sepsis case occurred. 96.5% of patients were stone-free (Grade A+B). Grade A SFR was 52.8%. All patients were discharged within 48 hours. Bone window (OR 3.156 95% CI 1.177-9.130, P=0.027) was the only factor significantly associated with higher odds of 100% SFR, while stone volume (OR 0.999, 95% CI 0.999-1.000, P=0.007) was significantly associated with lower odds.
Conclusions: Imaging and clinical evidence demonstrate excellent perioperative outcomes just 24 hours post RIRS with FANS-UAS. The technique demonstrates a good safety profile, ability for immediate high SFR, and a low rate of infective complications.
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