World journal of urology · 2024
Is flexible and navigable suction ureteral access sheath (FANS-UAS) the next best development for retrograde intrarenal surgery in children? Results of a prospective multicentre study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Gauhar Vineet, Madarriaga Yesica Quiroz, Somani Bhaskar, Joshi Rohit, Tanidir Yiloren, Castellani Daniele, Ragoori Deepak, Fong Khi Yung, Yuen Steffi Kar Kei, Tur Anna Bujons, Tursunkulov Azimdjon N, Vaddi Chandra Mohan
Аннотация
PURPOSE: To assess retrograde intrarenal surgery (RIRS) outcomes in children using ClearPetra, a flexible and navigable suction ureteral access sheath (FANS-UAS).
METHODS: Children with kidney stone(s) only undergoing RIRS in 8 centers were prospectively included (September 2023-May 2024).
EXCLUSION CRITERIA: ureteral stone, bilateral procedures, anomalous kidneys, surgery for residual fragments. Lithotripsy was performed using either a Holmium or Thulium fiber laser. Postoperative pain was assessed within 24 h using a 10-point visual analogue score. The use of FANS-UAS was graded by surgeons after each case using a 5-point likert scale. Low-dose non-contrast CT scan was performed before and within 30 days of RIRS to assess residual fragments (RFs). Stone-free status was defined as no RF or single RF up to 2 mm.
RESULTS: 50 children were included. 66% were male. Mean age was 6.6 (± 3.38) years. 88% stones were < 2 cm. one-third of the patients had a stone volume > 1500mm3. 10-12 Fr FANS-UAS was used in 98% of the procedure. The mean operative time was 46.02 (± 20.72) minutes. 2 patients had Traxer grade1 distal ureter and 2 forniceal injuries on sheath placement. Mean pain score was 2.18 (± 1.34). Mean likert scale was 1.16 (± 0.47) for ease of suction, 1.24 (± 0.52) for manipulation, 1.02 (± 0.32) for visibility. 4 patients had post-operative fever lasting less than 24 h. No sepsis occurred. Stone-free rate was 100%.
CONCLUSIONS: Our study shows that the use of FANS-UAS in paediatric RIRS is feasible and safe with a low rate of complications and excellent stone-free rate.
METHODS: Children with kidney stone(s) only undergoing RIRS in 8 centers were prospectively included (September 2023-May 2024).
EXCLUSION CRITERIA: ureteral stone, bilateral procedures, anomalous kidneys, surgery for residual fragments. Lithotripsy was performed using either a Holmium or Thulium fiber laser. Postoperative pain was assessed within 24 h using a 10-point visual analogue score. The use of FANS-UAS was graded by surgeons after each case using a 5-point likert scale. Low-dose non-contrast CT scan was performed before and within 30 days of RIRS to assess residual fragments (RFs). Stone-free status was defined as no RF or single RF up to 2 mm.
RESULTS: 50 children were included. 66% were male. Mean age was 6.6 (± 3.38) years. 88% stones were < 2 cm. one-third of the patients had a stone volume > 1500mm3. 10-12 Fr FANS-UAS was used in 98% of the procedure. The mean operative time was 46.02 (± 20.72) minutes. 2 patients had Traxer grade1 distal ureter and 2 forniceal injuries on sheath placement. Mean pain score was 2.18 (± 1.34). Mean likert scale was 1.16 (± 0.47) for ease of suction, 1.24 (± 0.52) for manipulation, 1.02 (± 0.32) for visibility. 4 patients had post-operative fever lasting less than 24 h. No sepsis occurred. Stone-free rate was 100%.
CONCLUSIONS: Our study shows that the use of FANS-UAS in paediatric RIRS is feasible and safe with a low rate of complications and excellent stone-free rate.