Multicenter outcome analysis of different sheath sizes for Flexible and Navigable Suction ureteral access sheath (FANS) ureteroscopy: an EAU Endourology collaboration with the global FANS study group

被引：3

作者：

Kwok, Jia-Lun ^{[1
,2
]}

Somani, Bhaskar ^{[3
]}

Sarica, Kemal ^{[4
,5
]}

Yuen, Steffi Kar Kei ^{[6
]}

Zawadzki, Marek ^{[7
]}

Castellani, Daniele ^{[8
]}

Persaud, Satyendra ^{[9
]}

Chai, Chu Ann ^{[10
]}

Kamal, Wissam ^{[11
]}

Tefik, Tzevat ^{[12
]}

Tursunkulov, Azimdjon N. ^{[13
]}

Soebhali, Boyke ^{[14
]}

El Hajj, Albert ^{[15
]}

Ko, Raymond ^{[16
]}

Fong, Khi Yung ^{[17
]}

Dragos, Laurian ^{[18
]}

Tanidir, Yiloren ^{[19
]}

Angerri, Oriol ^{[20
]}

Traxer, Olivier ^{[2
,21
]}

Gauhar, Vineet ^{[2
,22
]}

机构：

[1] Tan Tock Seng Hosp, Dept Urol, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore

[2] Progress Endourol Assoc Res & Leading Solut PEARLS, Paris, France

[3] Univ Hosp Southampton NHS Trust, Dept Urol, Southampton, England

[4] Prof Dr Ilhan Varank Training & Res Hosp, Dept Pediat, Istanbul, Turkiye

[5] Biruni Univ, Sch Med, Dept Urol, Istanbul, Turkiye

[6] Chinese Univ Hong Kong, SH Ho Urol Ctr, Dept Surg, Hong Kong, Peoples R China

[7] St Anna Hosp, Urol Unit, Piaseczno, Poland

[8] Univ Politecn Marche, Azienda Osped Univ Marche, Urol Unit, Ancona, Italy

[9] Univ West Indies, Div Clin Surg Sci, St Augustine, Trinidad Tobago

[10] Univ Kebangsaan Malaysia, Dept Surg, Urol Unit, Kuala Lumpur, Malaysia

[11] King Fahd Gen Hosp, Urol Unit, Jeddah, Saudi Arabia

[12] Istanbul Univ, Istanbul Fac Med, Dept Urol, Istanbul, Turkiye

[13] AkfaMedline Hosp, Dept Urol, Tashkent, Uzbekistan

[14] Abdul Wahab Sjahranie Hosp, Abdul Wahab Sjahranie Hosp, Dept Urol, Med Fac, Samarinda, Indonesia

[15] Amer Univ Beirut, Dept Surg, Div Urol, Beirut, Lebanon

[16] Univ Sydney, Nepean Hosp, Dept Urol, Sydney, Australia

[17] Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore, Singapore

[18] Cambridge Univ Hosp NHS Fdn Trust, Cambridge, England

[19] Marmara Univ, Sch Med, Dept Urol, Istanbul, Turkiye

[20] Univ Autonoma Barcelona, Dept Urol, Fundacio Puigvert, Barcelona, Spain

[21] Sorbonne Univ, Hop Tenon, AP HP, GRC 20 LITHIASE RENALE, F-75020 Paris, France

[22] Ng Teng Fong Gen Hosp, Dept Urol, Singapore, Singapore

来源：

UROLITHIASIS | 2024年 / 52卷 / 01期

关键词：

Flexible ureteroscopy; Lithotripsy; Flexible and navigable suction ureteral access sheaths; Suction; Sheath size;

D O I：

10.1007/s00240-024-01662-4

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Flexible and navigable suction ureteral access sheath (FANS) is a potential game changer in flexible ureteroscopy (FURS). The influence of sheath size on outcomes needs research. The primary aim was to analyze 30-day single stage stone free status (SFS), zero fragment rate (ZFR) and complications when using 10/12Fr sheaths vis a vis other sheath sizes. The global FANS research group published the 30-day outcomes in patients who underwent FANS and reasoned this can be a potential game changer. We included 295 patients from this anonymized dataset with division into two groups: Group 1 (Smaller sheath) - 10/12Fr FANS, and Group 2 (Larger sheath) - 11/13Fr or 12/14Fr sheaths. Stone volume was similar between both groups (median 1320 mm(3), p = 0.88). Ureteroscopy and total operative time was longer in the smaller sheath group (35 vs. 32 min, p = 0.02 and 50 vs. 45 min, p = 0.001, respectively). While 30-day computed tomography SFS (100% stone free or single residual fragment <= 2 mm) were not significantly different (96% vs. 95%, p > 0.99), ZFR (100% stone-free) was better with smaller sheaths (68% vs. 53%, p = 0.02). There was no difference in postoperative complication rates, and no sepsis in both groups. Urologists should consider individualizing appropriate sheath size in normal adult kidneys. Sheath size did not affect complication rates, risk of perioperative injury to the pelvicalyceal system or ureteric injury, but smaller FANS sheaths had similar high SFS. The ZFR with smaller sheaths was better, but this needs to be validated. These smaller sheath outcomes need to be balanced with longer ureteroscopy time, operative time, reach to the lower pole, ease of suction and visibility during lithotripsy. Large volume studies in different types of pelvicalyceal anatomy can determine if indeed smaller FANS is the best choice in FURS.

引用

页数：9

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