World journal of urology · 2025
Use of novel tip-bendable suction ureteral access sheath during retrograde intrarenal surgery for renal stones can reduce the risk of postoperative sepsis.
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Hongbo Xu, Kefeng Wu, Yilun Chen, Qinggang Wang, Meng Ding, Jianwen Li, Bing Lu, Shoujun Zhou, Jianquan Hou
Аннотация
BACKGROUND: Retrograde intrarenal surgery (RIRS) is widely used for treating renal stones, but postoperative sepsis remains a significant complication. This study aimed to evaluate whether the novel tip-bendable suction ureteral access sheath (S-UAS) reduces post-RIRS sepsis compared to traditional ureteral access sheaths (T-UAS).
METHODS: We retrospectively analyzed 233 patients undergoing RIRS for renal stones between February 2021 and October 2024. Patients were divided into S-UAS and T-UAS groups. The primary endpoint was postoperative sepsis, assessed using both the Systemic Inflammatory Response Syndrome (SIRS) and quick Sequential Organ Failure Assessment (qSOFA) criteria. Multivariate logistic regression was used to identify independent risk factors.
RESULTS: The S-UAS group showed significantly lower rates of postoperative fever (17.7% vs. 29.4%, p = 0.036), SIRS (7.3% vs. 22.0%, p = 0.001), and qSOFA criteria fulfillment (2.4% vs. 10.1%, p = 0.014). Immediate and 30-day stone-free rates were significantly higher with S-UAS (76.6% vs. 42.2%, p < 0.001 and 79.8% vs. 56.9%, p < 0.001, respectively). The median postoperative hospital stay was significantly lower in the S-UAS group compared to the T-UAS group (2d vs. 3d, p < 0.001). Multivariate analysis confirmed S-UAS as an independent protective factor against post-RIRS sepsis (OR 0.164, 95% CI 0.052-0.519, p = 0.002 for SIRS; OR 0.222, 95%CI 0.056-0.883, p = 0.033 for qSOFA).
CONCLUSION: The S-UAS significantly reduces the risk of postoperative sepsis following RIRS while improving stone-free rates.
METHODS: We retrospectively analyzed 233 patients undergoing RIRS for renal stones between February 2021 and October 2024. Patients were divided into S-UAS and T-UAS groups. The primary endpoint was postoperative sepsis, assessed using both the Systemic Inflammatory Response Syndrome (SIRS) and quick Sequential Organ Failure Assessment (qSOFA) criteria. Multivariate logistic regression was used to identify independent risk factors.
RESULTS: The S-UAS group showed significantly lower rates of postoperative fever (17.7% vs. 29.4%, p = 0.036), SIRS (7.3% vs. 22.0%, p = 0.001), and qSOFA criteria fulfillment (2.4% vs. 10.1%, p = 0.014). Immediate and 30-day stone-free rates were significantly higher with S-UAS (76.6% vs. 42.2%, p < 0.001 and 79.8% vs. 56.9%, p < 0.001, respectively). The median postoperative hospital stay was significantly lower in the S-UAS group compared to the T-UAS group (2d vs. 3d, p < 0.001). Multivariate analysis confirmed S-UAS as an independent protective factor against post-RIRS sepsis (OR 0.164, 95% CI 0.052-0.519, p = 0.002 for SIRS; OR 0.222, 95%CI 0.056-0.883, p = 0.033 for qSOFA).
CONCLUSION: The S-UAS significantly reduces the risk of postoperative sepsis following RIRS while improving stone-free rates.