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Contribution of Ureteral Access Sheath Use to The Efficacy of Semirigid Ureterorenoscopy in Upper Ureteral Stones Smaller Than 2 Cm: Experiences of A Single Center

Yıl 2022, Cilt 44, Sayı 1, 75 - 79, 30.03.2022
https://doi.org/10.7197/cmj.944685

Öz

Objective: The aim of our paper is to answer the question that during the ureteroscopy procedure if ureteral access sheath could facilitate operation, could decrease complication rates,operation time,requirement of additional surgery.
Method: The patients were randomly divided into two groups. Group 1 contained 44 patients for whom a UAS was not used and Group 2 consisted of 70 patients for whom a UAS was used during the URS procedure. The operation was continued using the semirigid ureteroscope within the UAS.
Results: There were no statistically significant differences between the two groups in terms of the mean age, BMI, ASA score, mean stone density, previous unsuccessful interventions, history of stone disease, mean grade of hydronephrosis in renal pelvis and mean stone size. the mean operation time was 41 minutes for Group 1 and 30 minutes for Group 2, with a statistically significant difference (p < 0.001), consistent with the literature. Similarly, the difference in the mean fluoroscopy time was statistically significant, being determined as six minutes for Group 1 and three minutes for Group 2 (p < 0.001).
Conclusions: Use of UAS was statistically significantly superior in terms of many parameters, such as increased stone-free rate, shorter operation time, and reduced requirement of additional surgery. Furthermore, the complication rates did not significantly differ between the UAS and non-UAS groups. We also consider that the advantages of a higher stone-free rate and reduced requirement of secondary interventions make the cost of UAS acceptable.

Kaynakça

  • 1. Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck AC, Gallucci M., et al; American Urological Association Education and Research, Inc; European Association of Urology. 2007 Guideline for the management of ureteral calculi. Eur Urol 2007;52:1610–1631.
  • 2. Bader MJ, Eisner B, Porpiglia F, Preminger GM, Tiselius HG.. Contemporary management of ureteral stones. Eur Urol 2012;61:764-72. http://dx.doi.org/10.1016/j.eururo.2012.01.009
  • 3. Gnanapragasam VJ, Ramsden PD, Murthy LS, Thomas DJ. Primary in situ extracorporeal shock wave lithotripsy in the management of ureteric calculi: Results with a third-generation lithotripter. Br J Urol 1999;84:770–774.
  • 4. Stewart GD, Bariol SV, Moussa SA, Smith G, Tolley DA. Matched pair analysis of ureteroscopy vs. shock wave lithotripsy for the treatment of upper ureteric calculi. Int J Clin Pract 2007; 61:784–788
  • 5. Lam JS, Greene TD, Gupta M. Treatment of proximal ureteral calculi: Holmium:YAG laser ureterolithotripsy versus extracorporeal shock wave lithotripsy. J Urol 2002;167:1972– 1976.
  • 6. Fong YK, Ho SH, Peh OH, Ng FC, Lim PH, Quek PL et al. Extracorporeal shock wave lithotripsy and intracorporeal lithotripsy for proximal ureteral calculi—a comparative assessment of efficacy and safety. Ann Acad Med Singapore 2004;33:80–83.
  • 7. Wu CF, Shee JJ, Lin WY, Lin CL, Chen CS.. Comparison between extracorporeal shock wave lithotripsy and semirigid ureterorenoscope with holmium:YAG laser lithotripsy for treating large proximal ureteral stones. J Urol 2004;172: 1899–1902.
  • 8. Rehman J, Monga M, Landman J, Lee DI, Felfela T, Conradie MC. Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths. Urology 2003;61:713–718.
  • 9. Auge BK, Pietrow PK, Lallas CD, Raj GV, Santa-Cruz RW, Preminger GM. Ureteral access sheath provides protection against elevated renal pressures during routine flexible ureteroscopic stone manipulation. J Endourol 2004;18:33–36.
  • 10. Newman RC, Hunter PT, Hawkins IF, Finlayson B. The ureteral access system: A review of the immediate results in 43 cases. J Urol 1987;137:380–383.
  • 11. Traxer O, Wendt-Nordahl G, Sodha H, Rassweiler J, Meretyk S, Tefekli A.et al. Differences in renal stone treatment and outcomes for patients treated either with or without the support of a ureteral access sheath: The Clinical Research Office of the Endourological Society Ureteroscopy Global Study. World J Urol. 2015 Dec;33(12):2137-44. doi: 10.1007/s00345-015-1582-8. Epub 2015 May 14.
  • 12. Vanlangendonck R, Landman J. Ureteral access strategies: pro-access sheath. Urol Clin North Am.2004; 31(1):71±81. https://doi.org/10.1016/S0094-0143(03)00095-8 PMID: 15040403
  • 13. Breda A, Ogunyemi O, Leppert JT, Schulam PG. Flexible ureteroscopy and laser lithotripsy for multiple unilateral intrarenal stones. Eur Urol. 2009;(5):1190±6. https://doi.org/10.1016/j.eururo.2008.06.019 PMID: 18571315
  • 14. Breda A, Territo A, LoÂpez-MartõÂnez JM. Benefits and risks of ureteral access sheaths for retrograde renal access. Curr Opin Urol. 2016;(1):70±5. https://doi.org/10.1097/MOU.0000000000000233 PMID:26555688
  • 15. Rehman J, Monga M, Landman J, Lee DI, Felfela T, Conradie MC, et al. Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths. Urology. 2003; 61(4):713±8. PMID: 12670551
  • 16. Scarpa RM, De Lisa A, Porru D, Usai E: Large benign prostatic hyperplasia means impossible ureteroscopy: Myth or reality? Eur Urol 2000;37:381–385.
  • 17.Berquet G, Prunel P, Verhoest G, Mathieu R, Bensalah K. The use of a ureteral access sheath does not improve stone-free rate after ureteroscopy for upper urinary tract stones. World J Urol. 2014; 32 (1):229±32. https://doi.org/10.1007/s00345-013-1181-5 PMID: 24166287
  • 18. Abrahams HM, Stoller ML. The argument against the routine use of ureteral access sheaths. Urol Clin North Am. 2004; 31(1):83±7. https://doi.org/10.1016/S0094-0143(03)00085-5 PMID: 15040404
  • 19. Rizkala ER, Monga M. Controversies in ureteroscopy: wire, basket, and sheath. Indian J Urol. 2013; 29
  • 20.De Sio M, Autorino R, Damiano R, Oliva A, Pane U, D'Armiento M. Expanding applications of the access sheath to ureterolithotripsy of distal ureteral stones. A frustrating experience. Urol Int. 2004; 72 Suppl 1:55±7. https://doi.org/10.1159/000076595 PMID: 15133337.
  • 21. Kourambas J, Byrne RR, Preminger GM: Does a ureteral access sheath facilitate ureteroscopy? J Urol 2001;165:789–793.

Yıl 2022, Cilt 44, Sayı 1, 75 - 79, 30.03.2022
https://doi.org/10.7197/cmj.944685

Öz

Kaynakça

  • 1. Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck AC, Gallucci M., et al; American Urological Association Education and Research, Inc; European Association of Urology. 2007 Guideline for the management of ureteral calculi. Eur Urol 2007;52:1610–1631.
  • 2. Bader MJ, Eisner B, Porpiglia F, Preminger GM, Tiselius HG.. Contemporary management of ureteral stones. Eur Urol 2012;61:764-72. http://dx.doi.org/10.1016/j.eururo.2012.01.009
  • 3. Gnanapragasam VJ, Ramsden PD, Murthy LS, Thomas DJ. Primary in situ extracorporeal shock wave lithotripsy in the management of ureteric calculi: Results with a third-generation lithotripter. Br J Urol 1999;84:770–774.
  • 4. Stewart GD, Bariol SV, Moussa SA, Smith G, Tolley DA. Matched pair analysis of ureteroscopy vs. shock wave lithotripsy for the treatment of upper ureteric calculi. Int J Clin Pract 2007; 61:784–788
  • 5. Lam JS, Greene TD, Gupta M. Treatment of proximal ureteral calculi: Holmium:YAG laser ureterolithotripsy versus extracorporeal shock wave lithotripsy. J Urol 2002;167:1972– 1976.
  • 6. Fong YK, Ho SH, Peh OH, Ng FC, Lim PH, Quek PL et al. Extracorporeal shock wave lithotripsy and intracorporeal lithotripsy for proximal ureteral calculi—a comparative assessment of efficacy and safety. Ann Acad Med Singapore 2004;33:80–83.
  • 7. Wu CF, Shee JJ, Lin WY, Lin CL, Chen CS.. Comparison between extracorporeal shock wave lithotripsy and semirigid ureterorenoscope with holmium:YAG laser lithotripsy for treating large proximal ureteral stones. J Urol 2004;172: 1899–1902.
  • 8. Rehman J, Monga M, Landman J, Lee DI, Felfela T, Conradie MC. Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths. Urology 2003;61:713–718.
  • 9. Auge BK, Pietrow PK, Lallas CD, Raj GV, Santa-Cruz RW, Preminger GM. Ureteral access sheath provides protection against elevated renal pressures during routine flexible ureteroscopic stone manipulation. J Endourol 2004;18:33–36.
  • 10. Newman RC, Hunter PT, Hawkins IF, Finlayson B. The ureteral access system: A review of the immediate results in 43 cases. J Urol 1987;137:380–383.
  • 11. Traxer O, Wendt-Nordahl G, Sodha H, Rassweiler J, Meretyk S, Tefekli A.et al. Differences in renal stone treatment and outcomes for patients treated either with or without the support of a ureteral access sheath: The Clinical Research Office of the Endourological Society Ureteroscopy Global Study. World J Urol. 2015 Dec;33(12):2137-44. doi: 10.1007/s00345-015-1582-8. Epub 2015 May 14.
  • 12. Vanlangendonck R, Landman J. Ureteral access strategies: pro-access sheath. Urol Clin North Am.2004; 31(1):71±81. https://doi.org/10.1016/S0094-0143(03)00095-8 PMID: 15040403
  • 13. Breda A, Ogunyemi O, Leppert JT, Schulam PG. Flexible ureteroscopy and laser lithotripsy for multiple unilateral intrarenal stones. Eur Urol. 2009;(5):1190±6. https://doi.org/10.1016/j.eururo.2008.06.019 PMID: 18571315
  • 14. Breda A, Territo A, LoÂpez-MartõÂnez JM. Benefits and risks of ureteral access sheaths for retrograde renal access. Curr Opin Urol. 2016;(1):70±5. https://doi.org/10.1097/MOU.0000000000000233 PMID:26555688
  • 15. Rehman J, Monga M, Landman J, Lee DI, Felfela T, Conradie MC, et al. Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths. Urology. 2003; 61(4):713±8. PMID: 12670551
  • 16. Scarpa RM, De Lisa A, Porru D, Usai E: Large benign prostatic hyperplasia means impossible ureteroscopy: Myth or reality? Eur Urol 2000;37:381–385.
  • 17.Berquet G, Prunel P, Verhoest G, Mathieu R, Bensalah K. The use of a ureteral access sheath does not improve stone-free rate after ureteroscopy for upper urinary tract stones. World J Urol. 2014; 32 (1):229±32. https://doi.org/10.1007/s00345-013-1181-5 PMID: 24166287
  • 18. Abrahams HM, Stoller ML. The argument against the routine use of ureteral access sheaths. Urol Clin North Am. 2004; 31(1):83±7. https://doi.org/10.1016/S0094-0143(03)00085-5 PMID: 15040404
  • 19. Rizkala ER, Monga M. Controversies in ureteroscopy: wire, basket, and sheath. Indian J Urol. 2013; 29
  • 20.De Sio M, Autorino R, Damiano R, Oliva A, Pane U, D'Armiento M. Expanding applications of the access sheath to ureterolithotripsy of distal ureteral stones. A frustrating experience. Urol Int. 2004; 72 Suppl 1:55±7. https://doi.org/10.1159/000076595 PMID: 15133337.
  • 21. Kourambas J, Byrne RR, Preminger GM: Does a ureteral access sheath facilitate ureteroscopy? J Urol 2001;165:789–793.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Cerrahi Tıp Bilimleri Araştırma Yazıları
Yazarlar

Ali Haydar YILMAZ (Sorumlu Yazar)
Bilecik Eğitim ve Araştırma Hastanesi
0000-0001-5797-0655
Türkiye


Ahmet CİNİSLİOĞLU
UNIVERSITY OF HEALTH SCIENCES, ERZURUM REGION HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES
0000-0002-1037-815X
Türkiye

Yayımlanma Tarihi 30 Mart 2022
Yayınlandığı Sayı Yıl 2022, Cilt 44, Sayı 1

Kaynak Göster

APA Yılmaz, A. H. & Cinislioğlu, A. (2022). Contribution of Ureteral Access Sheath Use to The Efficacy of Semirigid Ureterorenoscopy in Upper Ureteral Stones Smaller Than 2 Cm: Experiences of A Single Center . Cumhuriyet Medical Journal , 44 (1) , 75-79 . DOI: 10.7197/cmj.944685