Мақола

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

Vineet GauharDepartment of Urology, Ng Teng Fong General Hospital, Singapore, SingaporeOlivier TraxerAssistance Publique – Hôpitaux de ParisDaniele CastellaniUnit of Urology, Marche Polytechnic University, Azienda Ospedaliero-Universitaria (AOU) delle Marche, Ancona, Italy - [email protected]K.Y. FongYong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeSaeed Bin HamriMehmet Ilker GökceDepartment of Urology, Ankara University School of Medicine, Ankara, TürkiyeNariman GadzhievDepartment of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg, RussiaMariela CorralesHôpital TenonVigen MalkhasyanDepartment of Urology, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, RussiaDeepak RagooriAsian Institute of GastroenterologyBoyke SoebhaliDepartment of Urology, Abdul Wahab Sjahranie Hospital Medical Faculty, Muliawarman University, Samarinda, IndonesiaKarl TanSection of Urology, Department of Surgery, Veterans Memorial Medical Center, Quezon, PhilippinesChu Ann ChaiUnit of Urology, Department of Surgery, University of Malaya, Kuala Lumpur, MalaysiaAzimdjon TursunkulovDivision of Urology, AkfaMedline Hospital, Tashkent, UzbekistanYiloren TanidirUnit of Urology, Marmara University Pendik Research and Education Hospital, Istanbul, TürkiyeSatyendra PersaudDivision of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and TobagoMohamed El-ShazlyUnit of Urology, Menoufia University, Shibin el Kom, EgyptWissam KamalUnit of Urology, King Fahd General Hospital, Jeddah, Saudi ArabiaTzevat TefikDepartment of Urology, Istanbul University, Faculty of Medicine, Istanbul, TürkiyeAnil ShresthaNational Academy of Medical SciencesB.H. ChewDepartment of Urology, University of British Columbia, Vancouver, BC, CanadaMohamed Amine LakmichiDepartment of Urology, University Hospital Mohammed the VIth of Marrakesh, Marrakesh, MoroccoAndrea Benedetto GalosiUnit of Urology, Marche Polytechnic University, Azienda Ospedaliero-Universitaria (AOU) delle Marche, Ancona, ItalyHeng Chin TiongDepartment of Urology, Ng Teng Fong General Hospital, Singapore, SingaporeChristian SeitzDepartment of Urology Medical University of Vienna, Vienna, AustriaBhaskar K. SOMANI

2024en

ABI

Аннотация

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: (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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DOI: 10.23736/s2724-6051.24.05961-5

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