Journal article
Increasing the size of ureteral access sheath during retrograde intrarenal surgery improves surgical efficiency without increasing complications
World journal of urology, Vol.36(6), pp.971-978
06/2018
DOI: 10.1007/s00345-018-2204-z
PMID: 29380131
Abstract
To directly compare intraoperative and post-operative outcomes and complications between three groups undergoing ureteroscopy: no ureteral access sheath, 12/14 Fr and larger 14/16 Fr ureteral access sheaths (UAS).We retrospectively reviewed demographic, pre-operative, intraoperative, and post-operative data of 257 patients who underwent ureteroscopy for nephrolithiasis by a single surgeon from January 2013 through July 2015. Patients were separated into three groups: no UAS, a 12/14 Fr UAS, or 14/16 Fr UAS. Outcomes included differences in stone-free rate, post-procedure-related events (PRE), ureteral injury rate (measured by early post-operative hydronephrosis), and post-operative complications.A UAS was used in 65.4% (168/257) patients, with 73.8% (124/168) utilizing a 12/14 Fr UAS and 26.2% (44/168) utilizing a 14/16 Fr UAS. Those patients in whom a 14/16 Fr UAS was employed had greater stone burden compared to the 12/14 Fr UAS group (180.8 ± 18.0 vs. 104 ± 9.1 mm2, p < 0.001). When comparing 12/14 Fr and 14/16 Fr ureteral access sheaths, there was no significant difference in ureteral injury rate, complications (10.5 vs. 11.4%, respectively; p = 0.87), or overall stone-free rate (78.1 vs. 81.3%, p = 0.70). The mean amount of stone burden treated per minute of operative time was more than 30% higher in the 14/16 Fr UAS group compared to 12/14 Fr UAS group (2.11 vs. 1.62 mm2/min; p = 0.01).The use of a 14/16 Fr UAS allows for similar stone-free rate and improved operative efficiency with no increased risk of ureteral injury or post-operative complications when compared to the 12/14 Fr UAS.
Details
- Title: Subtitle
- Increasing the size of ureteral access sheath during retrograde intrarenal surgery improves surgical efficiency without increasing complications
- Creators
- Chad Tracy - 0000 0004 1936 8294 grid.214572.7 Department of Urology University of Iowa 200 Hawkins Dr., 3 RCP Iowa City IA 52242-1089 USAGeorge Ghareeb - 0000 0004 1936 8294 grid.214572.7 Department of Urology University of Iowa 200 Hawkins Dr., 3 RCP Iowa City IA 52242-1089 USACharles Paul - 0000 0004 1936 8294 grid.214572.7 Department of Urology University of Iowa 200 Hawkins Dr., 3 RCP Iowa City IA 52242-1089 USANathan Brooks - 0000 0004 1936 8294 grid.214572.7 Department of Urology University of Iowa 200 Hawkins Dr., 3 RCP Iowa City IA 52242-1089 USA
- Resource Type
- Journal article
- Publication Details
- World journal of urology, Vol.36(6), pp.971-978
- Publisher
- Springer Berlin Heidelberg; Berlin/Heidelberg
- DOI
- 10.1007/s00345-018-2204-z
- PMID
- 29380131
- ISSN
- 0724-4983
- eISSN
- 1433-8726
- Grant note
- Watts Family Fellowship in Urologic Research
- Language
- English
- Date published
- 06/2018
- Academic Unit
- Radiology; Urology
- Record Identifier
- 9984051874602771
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