Felipe Giraldo Alvarez Gonçalves, Breno Cordeiro Porto, Bruno Damico Terada, João Victor Gruner Turco Spilborghs, Carlo Camargo Passerotti, Rodrigo A S Sardenberg, Jose Pinhata Otoch, Jose Arnaldo Shiomi Da Cruz
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The primary endpoint was the stone-free rate (SFR), while adverse effects, operative time, fever rate, and hospital stay were analyzed as secondary outcomes.</p><p><strong>Results: </strong>We retrieved 8 articles, encompassing a total of 2,255 patients, with 978 in the S-UAS group and 1,247 in the T-UAS group. Our analysis revealed a higher SFR in the S-UAS group after 1 day, and also at later time points (one or three months) (OR 3.79; 95% CI 1.70-8.46; p = 0.001; I<sup>2</sup> = 89.2%) and (OR 1.98; 95% CI 1.52-2.59; p < 0.001; I<sup>2</sup> = 0%), respectively. Regarding surgical complications, we observed a lower incidence in the S-UAS group (OR 0.37; 95% CI 0.26-0.51; p < 0.001; I<sup>2</sup> = 0%), as well as a reduced fever rate (OR 0.34; 95% CI 0.24-0.48; p < 0.001; I<sup>2</sup> = 0%) and a shorter length of hospital stay (MD -0.11; 95% CI -0.16 to -0.05; p < 0.001; I<sup>2</sup> = 39.6%). No differences were found in the operative time between both approaches (MD -2.49; 95% CI -7.62-2.65; p < 0.343; I<sup>2</sup> = 88.3%).</p><p><strong>Conclusion: </strong>Our study suggests that using S-UAS in RIRS may enhance the SFR, and also reduce both complications and hospital stay.</p><p><strong>Trial registration: </strong>This systematic-review and meta-analysis was prospectively registered on PROSPERO under protocol CRD42024543084.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"25 1","pages":"86"},"PeriodicalIF":1.9000,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987389/pdf/","citationCount":"0","resultStr":"{\"title\":\"Enhanced stone-free rates with suctioning ureteral access sheath vs. traditional sheath in retrograde intrarenal surgery: a systematic review and meta-analysis.\",\"authors\":\"Felipe Giraldo Alvarez Gonçalves, Breno Cordeiro Porto, Bruno Damico Terada, João Victor Gruner Turco Spilborghs, Carlo Camargo Passerotti, Rodrigo A S Sardenberg, Jose Pinhata Otoch, Jose Arnaldo Shiomi Da Cruz\",\"doi\":\"10.1186/s12894-025-01775-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>As a safe approach to the upper urinary tract, flexible ureteroscopic lithotripsy (fURL) is a widely accepted treatment for nephrolithiasis. 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引用次数: 0
摘要
背景:作为一种安全的上尿路输尿管镜碎石术(fURL)是一种被广泛接受的治疗肾结石的方法。有时,这种技术可以依靠自然排出结石,增加感染和结石复发的风险。为了缓解这些问题,一些研究尝试使用吸引输尿管通路鞘(S-UAS)。方法:通过多个数据库对S-UAS与传统(T-UAS)在逆行肾内手术(RIRS)中的试验进行系统评价。主要终点是无结石率(SFR),而不良反应、手术时间、发热率和住院时间作为次要终点进行分析。结果:我们检索到8篇文章,共包含2255例患者,其中978例为S-UAS组,1247例为T-UAS组。我们的分析显示,S-UAS组在1天后以及以后的时间点(1或3个月)的SFR较高(or 3.79;95% ci 1.70-8.46;p = 0.001;I2 = 89.2%)和(OR 1.98;95% ci 1.52-2.59;P 2 = 0%)。至于手术并发症,我们观察到S-UAS组的发生率较低(OR 0.37;95% ci 0.26-0.51;p 2 = 0%),发热率降低(OR 0.34;95% ci 0.24-0.48;p 2 = 0%)和较短的住院时间(MD -0.11;95% CI -0.16 ~ -0.05;p 2 = 39.6%)。两种入路手术时间无差异(MD -2.49;95% ci -7.62-2.65;p 2 = 88.3%)。结论:我们的研究表明,在RIRS中使用S-UAS可以提高SFR,并减少并发症和住院时间。试验注册:该系统评价和荟萃分析在PROSPERO上前瞻性注册,注册方案为CRD42024543084。
Enhanced stone-free rates with suctioning ureteral access sheath vs. traditional sheath in retrograde intrarenal surgery: a systematic review and meta-analysis.
Background: As a safe approach to the upper urinary tract, flexible ureteroscopic lithotripsy (fURL) is a widely accepted treatment for nephrolithiasis. Sometimes, this technique can rely on the natural expulsion of stones, increasing the risk of infections and stone recurrence. To mitigate these issues, some studies tried to use a suctioning ureteral access sheath (S-UAS).
Methods: A systematic review was conducted across multiple databases for trials comparing S-UAS with traditional (T-UAS) in retrograde intrarenal surgery (RIRS). The primary endpoint was the stone-free rate (SFR), while adverse effects, operative time, fever rate, and hospital stay were analyzed as secondary outcomes.
Results: We retrieved 8 articles, encompassing a total of 2,255 patients, with 978 in the S-UAS group and 1,247 in the T-UAS group. Our analysis revealed a higher SFR in the S-UAS group after 1 day, and also at later time points (one or three months) (OR 3.79; 95% CI 1.70-8.46; p = 0.001; I2 = 89.2%) and (OR 1.98; 95% CI 1.52-2.59; p < 0.001; I2 = 0%), respectively. Regarding surgical complications, we observed a lower incidence in the S-UAS group (OR 0.37; 95% CI 0.26-0.51; p < 0.001; I2 = 0%), as well as a reduced fever rate (OR 0.34; 95% CI 0.24-0.48; p < 0.001; I2 = 0%) and a shorter length of hospital stay (MD -0.11; 95% CI -0.16 to -0.05; p < 0.001; I2 = 39.6%). No differences were found in the operative time between both approaches (MD -2.49; 95% CI -7.62-2.65; p < 0.343; I2 = 88.3%).
Conclusion: Our study suggests that using S-UAS in RIRS may enhance the SFR, and also reduce both complications and hospital stay.
Trial registration: This systematic-review and meta-analysis was prospectively registered on PROSPERO under protocol CRD42024543084.
期刊介绍:
BMC Urology is an open access journal publishing original peer-reviewed research articles in all aspects of the prevention, diagnosis and management of urological disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
The journal considers manuscripts in the following broad subject-specific sections of urology:
Endourology and technology
Epidemiology and health outcomes
Pediatric urology
Pre-clinical and basic research
Reconstructive urology
Sexual function and fertility
Urological imaging
Urological oncology
Voiding dysfunction
Case reports.