Multi-aspect analysis of ureteral access sheath usage in retrograde intrarenal surgery: A RIRSearch group study  

作　　者：Oktay Özman Hacı M.Akgül Cem Başataç Önder Çınar Eyüp B.Sancak Cenk M.Yazıcı Bülent Önal Haluk Akpınar 

机构地区：[1]Gaziosmanpasa Training and Research Hospital,Urology Clinic,İstanbul,Turkey [2]TekirdağNamık Kemal University,School of Medicine,Department of Urology,Tekirdağ,Turkey [3]Group Florence Nightingale Hospitals,Department of Urology,İstanbul,Turkey [4]Zonguldak Bulent Ecevit University,School of Medicine,Department of Urology,Zonguldak,Turkey [5]Çanakkale Onsekiz Mart University,School of Medicine,Department of Urology,Çanakkale,Turkey [6]İstanbul University-Cerrahpaşa,Cerrahpaşa Medical Faculty,Department of Urology,İstanbul,Turkey

出　　处：《Asian Journal of Urology》2024年第1期80-85,共6页亚洲泌尿外科杂志（英文）

摘　　要：Objective:To evaluate the effect of ureteral access sheath(UAS)use and calibration change on stone-free rate and complications of retrograde intrarenal surgery(RIRS).Methods:Data from 568 patients undergoing RIRS for kidney or upper ureteral stones were retrospectively included.Firstly,patients were compared after 1:1 propensity score matching,according to UAS usage during RIRS(UAS used[+]87 and UAS non-used[−]87 patients).Then all UAS+patients(n=481)were subdivided according to UAS calibration:9.5-11.5 Fr,10-12 Fr,11-13 Fr,and 13-15 Fr.Primary outcomes of the study were the success and complications of RIRS.Results:Stone-free rate of UAS+patients(86.2%)was significantly higher than UAS−patients(70.1%)after propensity score matching(p=0.01).Stone-free rate increased with higher caliber UAS(9.5-11.5 Fr:66.7%;10-12 Fr:87.0%;11-13 Fr:90.6%;13-15 Fr:100%;p<0.001).Postoperative complications of UAS+patients(11.5%)were significantly lower than UAS−patients(27.6%)(p=0.01).Complications(8.7%)with 9.5-11.5 Fr UAS was lower than thicker UAS(17.2%)but was not statistically significant(p=0.09).UAS usage was an independent factor predicting stone-free status or peri-and post-operative complications(odds ratio[OR]3.654,95%confidence interval[CI]1.314-10.162;OR 4.443,95%CI 1.350-14.552;OR 4.107,95%CI 1.366-12.344,respectively).Conclusion:Use of UAS in RIRS may increase stone-free rates,which also increase with higher caliber UAS.UAS usage may reduce complications;however,complications seemingly increase with higher UAS calibration.

关 键 词：STONE Retrograde intrarenal surgery Ureteral access sheath UROLITHIASIS Kidney 

分 类 号：R699.2[医药卫生—泌尿科学]