Comparison of suctioning and traditional ureteral access sheath during flexible ureteroscopy in the treatment of renal stones
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To compare the efficiency and safety of suctioning ureteral access sheath (UAS) and traditional UAS during flexible ureteroscopy (FURS) for treatment of renal stones.
Between January 2015 and December 2017, 165 patients who had renal stones successfully underwent FURS with suctioning UAS created by connecting a channel on the tail of the suctioning UAS to a vacuum device. The outcomes of these patients were compared with those of 165 patients undergoing FURS with traditional UAS using a 1:1 scenario matched-pair analysis. The matching parameters were age, gender and stone burden.
The baseline characteristics were homogeneous between the two groups. The suctioning UAS group had significantly higher SFR one day postoperatively (82.4% vs. 71.5%; P = 0.02), but SFR 1 month postoperatively was comparable in the two groups (P = 0.13). The incidence of overall complications was significantly higher in the traditional UAS group (24.8% vs 11.5%; P < 0.001). Regarding individual complications, the traditional UAS group was associated with a significantly higher incidence of fever (13.9% vs 5.5%; P = 0.009) and urosepsis requiring only additional antibiotics (6.7% vs 1.8%; P = 0.029). No significant difference was noted in the incidence of septic shock, hematuria, steinstrasse or ureteral stricture. The suctioning UAS group had significantly shorter operative time (49.7 + 16.3 min vs. 57.0 ± 14.0 min; P < 0.001).
Compared to traditional UAS during FURS for treating renal stones, suctioning UAS had the advantages of higher SFR 1 day postoperatively, a lower incidence of infectious complications and a shorter operative time. Further well-designed studies are required to confirm the results.
KeywordsRenal stone Flexible ureteroscopy Ureteral access sheath
We would like to thank the National Natural Science Foundation of China, the Nature Science Foundation of Hunan Province, and the Key Research and Development Projects of the Hunan Science and Technology Department for providing funding for this study.
ZZ: project development, data collection and manuscript writing. YC: data collection and analysis. FZ: data collection. YL: data collection. ZC: data analysis. CH: project development.
Funding was provided by the National Natural Science Foundation of China (81770705 to Hequn Chen), the Nature Science Foundation of Hunan Province, China (2017JJ2395 to Yang Li) and Key Research and Development Projects of the Hunan Science and Technology Department (2016JC2041 to Hequn Chen).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
Written informed consent to surgical procedures and to the publication of clinical data on the condition of anonymity was obtained preoperatively from all included patients. The study was approved by the Ethics Committee of the Xiangya Hospital of Central South University (proof number: 201806889).
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