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Could Use of a Flexible and Navigable Suction Ureteral Access Sheath Be a Potential Game-changer in Retrograde Intrarenal Surgery? Outcomes at 30 Days from a Large, Prospective, Multicenter, Real-world Study by the European Association of Urology Urolithiasis Section. / Gauhar, Vineet; Traxer, Olivier; Castellani, Daniele; Sietz, Christian; Chew, Ben Hall; Fong, Khi Yung; Hamri, Saeed Bin; Gökce, Mehmet Ilker; Gadzhiev, Nariman; Galosi, Andrea Benedetto; Yuen, Steffi Kar Kei; El Hajj, Albert; Ko, Raymond; Zawadzki, Marek; Sridharan, Vikram; Lakmichi, Mohamed Amine; Corrales, Mariela; Malkhasyan, Vigen; Ragoori, Deepak; Soebhali, Boyke; Tan, Karl; Chai, Chu Ann; Tursunkulov, Azimdjon N; Tanidir, Yiloren; Persaud, Satyendra; Elshazly, Mohamed; Kamal, Wissam; Tefik, Tzevat; Shrestha, Anil; Tiong, Heng Chin; Somani, Bhaskar Kumar.

In: European Urology Focus, Vol. 10, No. 6, 12.2024, p. 975-982.

Research output: Contribution to journal › Article › peer-review

Harvard

Gauhar, V, Traxer, O, Castellani, D, Sietz, C, Chew, BH, Fong, KY, Hamri, SB, Gökce, MI, Gadzhiev, N, Galosi, AB, Yuen, SKK, El Hajj, A, Ko, R, Zawadzki, M, Sridharan, V, Lakmichi, MA, Corrales, M, Malkhasyan, V, Ragoori, D, Soebhali, B, Tan, K, Chai, CA, Tursunkulov, AN, Tanidir, Y, Persaud, S, Elshazly, M, Kamal, W, Tefik, T, Shrestha, A, Tiong, HC & Somani, BK 2024, 'Could Use of a Flexible and Navigable Suction Ureteral Access Sheath Be a Potential Game-changer in Retrograde Intrarenal Surgery? Outcomes at 30 Days from a Large, Prospective, Multicenter, Real-world Study by the European Association of Urology Urolithiasis Section', European Urology Focus, vol. 10, no. 6, pp. 975-982. https://doi.org/10.1016/j.euf.2024.05.010

APA

Gauhar, V., Traxer, O., Castellani, D., Sietz, C., Chew, B. H., Fong, K. Y., Hamri, S. B., Gökce, M. I., Gadzhiev, N., Galosi, A. B., Yuen, S. K. K., El Hajj, A., Ko, R., Zawadzki, M., Sridharan, V., Lakmichi, M. A., Corrales, M., Malkhasyan, V., Ragoori, D., ... Somani, B. K. (2024). Could Use of a Flexible and Navigable Suction Ureteral Access Sheath Be a Potential Game-changer in Retrograde Intrarenal Surgery? Outcomes at 30 Days from a Large, Prospective, Multicenter, Real-world Study by the European Association of Urology Urolithiasis Section. European Urology Focus, 10(6), 975-982. https://doi.org/10.1016/j.euf.2024.05.010

Vancouver

Gauhar V, Traxer O, Castellani D, Sietz C, Chew BH, Fong KY et al. Could Use of a Flexible and Navigable Suction Ureteral Access Sheath Be a Potential Game-changer in Retrograde Intrarenal Surgery? Outcomes at 30 Days from a Large, Prospective, Multicenter, Real-world Study by the European Association of Urology Urolithiasis Section. European Urology Focus. 2024 Dec;10(6):975-982. https://doi.org/10.1016/j.euf.2024.05.010

Author

Gauhar, Vineet ; Traxer, Olivier ; Castellani, Daniele ; Sietz, Christian ; Chew, Ben Hall ; Fong, Khi Yung ; Hamri, Saeed Bin ; Gökce, Mehmet Ilker ; Gadzhiev, Nariman ; Galosi, Andrea Benedetto ; Yuen, Steffi Kar Kei ; El Hajj, Albert ; Ko, Raymond ; Zawadzki, Marek ; Sridharan, Vikram ; Lakmichi, Mohamed Amine ; Corrales, Mariela ; Malkhasyan, Vigen ; Ragoori, Deepak ; Soebhali, Boyke ; Tan, Karl ; Chai, Chu Ann ; Tursunkulov, Azimdjon N ; Tanidir, Yiloren ; Persaud, Satyendra ; Elshazly, Mohamed ; Kamal, Wissam ; Tefik, Tzevat ; Shrestha, Anil ; Tiong, Heng Chin ; Somani, Bhaskar Kumar. / Could Use of a Flexible and Navigable Suction Ureteral Access Sheath Be a Potential Game-changer in Retrograde Intrarenal Surgery? Outcomes at 30 Days from a Large, Prospective, Multicenter, Real-world Study by the European Association of Urology Urolithiasis Section. In: European Urology Focus. 2024 ; Vol. 10, No. 6. pp. 975-982.

BibTeX

@article{bc0059b2fec2415c93089fb148dc9e65,
title = "Could Use of a Flexible and Navigable Suction Ureteral Access Sheath Be a Potential Game-changer in Retrograde Intrarenal Surgery?: Outcomes at 30 Days from a Large, Prospective, Multicenter, Real-world Study by the European Association of Urology Urolithiasis Section",
abstract = "BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the stone-free status (SFS) rate and complications after flexible ureteroscopy (fURS) for treatment of renal stones using a flexible and navigable suction (FANS) ureteral access sheath.METHODS: Data for adults undergoing fURS in 25 centers worldwide were prospectively collected (August 2023 to January 2024). Exclusion criteria were abnormal renal anatomy and ureteral stones. All patients had computed tomography scans before and within 30 d after fURS with a FANS ureteral access sheath. SFS was defined as follows: grade A, zero fragments; grade B, a single fragment ≤2 mm; grade C, a single fragment 2.1-4 mm; and grade D, single/multiple fragments >4 mm. Data for continuous variables are presented as the median and interquartile range (IQR). Multivariable logistic regression was performed to evaluate predictors of grade A SFS.KEY FINDINGS AND LIMITATIONS: The study enrolled 394 patients (59.1% male) with a median age of 49 yr (IQR 36-61). The median stone volume was 1260 mm3 (IQR 706-1800). Thulium fiber laser (TFL) was used in 45.9% of cases and holmium laser in the rest. The median lasing time was 18 min (IQR 11-28) and the median operative time was 49 min (IQR 37-70). One patient required a blood transfusion and 3.3% of patients had low-grade fever. No patient developed sepsis. Low-grade ureteral injury occurred in eight patients (2%). The grade A SFS rate was 57.4% and the grade A + B SFS rate was 97.2%, while 2.8% of patients had grade C or D SFS. Eleven patients underwent repeat fURS. Multivariable analysis revealed that a stone volume of 1501-3000 mm3 (odds ratio 0.50) and of >3000 mm3 (odds ratio 0.29) were significantly associated with lower probability of grade A SFS, while TFL use was associated with higher SFS probability (odds ratio 1.83). Limitations include the lack of a comparative group.CONCLUSIONS AND CLINICAL IMPLICATIONS: fURS using a FANS ureteral access sheath resulted in a high SFS rate with negligible serious adverse event and reintervention rates.PATIENT SUMMARY: We looked at 30-day results for patients undergoing telescopic laser treatment for kidney stones using a special type of vacuum-assisted sheath to remove stone fragments. We found a high stone-free rate with minimal complications.",
keywords = "Humans, Male, Prospective Studies, Female, Middle Aged, Adult, Ureteroscopy/methods, Kidney Calculi/surgery, Treatment Outcome, Suction/instrumentation, Ureteroscopes, Postoperative Complications/epidemiology, Europe",
author = "Vineet Gauhar and Olivier Traxer and Daniele Castellani and Christian Sietz and Chew, {Ben Hall} and Fong, {Khi Yung} and Hamri, {Saeed Bin} and G{\"o}kce, {Mehmet Ilker} and Nariman Gadzhiev and Galosi, {Andrea Benedetto} and Yuen, {Steffi Kar Kei} and {El Hajj}, Albert and Raymond Ko and Marek Zawadzki and Vikram Sridharan and Lakmichi, {Mohamed Amine} and Mariela Corrales and Vigen Malkhasyan and Deepak Ragoori and Boyke Soebhali and Karl Tan and Chai, {Chu Ann} and Tursunkulov, {Azimdjon N} and Yiloren Tanidir and Satyendra Persaud and Mohamed Elshazly and Wissam Kamal and Tzevat Tefik and Anil Shrestha and Tiong, {Heng Chin} and Somani, {Bhaskar Kumar}",
note = "Copyright {\textcopyright} 2024 The Author(s). Published by Elsevier B.V. All rights reserved.",
year = "2024",
month = dec,
doi = "10.1016/j.euf.2024.05.010",
language = "English",
volume = "10",
pages = "975--982",
journal = "European Urology Focus",
issn = "2405-4569",
publisher = "Elsevier",
number = "6",

}

RIS

TY - JOUR

T1 - Could Use of a Flexible and Navigable Suction Ureteral Access Sheath Be a Potential Game-changer in Retrograde Intrarenal Surgery?

T2 - Outcomes at 30 Days from a Large, Prospective, Multicenter, Real-world Study by the European Association of Urology Urolithiasis Section

AU - Gauhar, Vineet

AU - Traxer, Olivier

AU - Castellani, Daniele

AU - Sietz, Christian

AU - Chew, Ben Hall

AU - Fong, Khi Yung

AU - Hamri, Saeed Bin

AU - Gökce, Mehmet Ilker

AU - Gadzhiev, Nariman

AU - Galosi, Andrea Benedetto

AU - Yuen, Steffi Kar Kei

AU - El Hajj, Albert

AU - Ko, Raymond

AU - Zawadzki, Marek

AU - Sridharan, Vikram

AU - Lakmichi, Mohamed Amine

AU - Corrales, Mariela

AU - Malkhasyan, Vigen

AU - Ragoori, Deepak

AU - Soebhali, Boyke

AU - Tan, Karl

AU - Chai, Chu Ann

AU - Tursunkulov, Azimdjon N

AU - Tanidir, Yiloren

AU - Persaud, Satyendra

AU - Elshazly, Mohamed

AU - Kamal, Wissam

AU - Tefik, Tzevat

AU - Shrestha, Anil

AU - Tiong, Heng Chin

AU - Somani, Bhaskar Kumar

N1 - Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

PY - 2024/12

Y1 - 2024/12

N2 - BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the stone-free status (SFS) rate and complications after flexible ureteroscopy (fURS) for treatment of renal stones using a flexible and navigable suction (FANS) ureteral access sheath.METHODS: Data for adults undergoing fURS in 25 centers worldwide were prospectively collected (August 2023 to January 2024). Exclusion criteria were abnormal renal anatomy and ureteral stones. All patients had computed tomography scans before and within 30 d after fURS with a FANS ureteral access sheath. SFS was defined as follows: grade A, zero fragments; grade B, a single fragment ≤2 mm; grade C, a single fragment 2.1-4 mm; and grade D, single/multiple fragments >4 mm. Data for continuous variables are presented as the median and interquartile range (IQR). Multivariable logistic regression was performed to evaluate predictors of grade A SFS.KEY FINDINGS AND LIMITATIONS: The study enrolled 394 patients (59.1% male) with a median age of 49 yr (IQR 36-61). The median stone volume was 1260 mm3 (IQR 706-1800). Thulium fiber laser (TFL) was used in 45.9% of cases and holmium laser in the rest. The median lasing time was 18 min (IQR 11-28) and the median operative time was 49 min (IQR 37-70). One patient required a blood transfusion and 3.3% of patients had low-grade fever. No patient developed sepsis. Low-grade ureteral injury occurred in eight patients (2%). The grade A SFS rate was 57.4% and the grade A + B SFS rate was 97.2%, while 2.8% of patients had grade C or D SFS. Eleven patients underwent repeat fURS. Multivariable analysis revealed that a stone volume of 1501-3000 mm3 (odds ratio 0.50) and of >3000 mm3 (odds ratio 0.29) were significantly associated with lower probability of grade A SFS, while TFL use was associated with higher SFS probability (odds ratio 1.83). Limitations include the lack of a comparative group.CONCLUSIONS AND CLINICAL IMPLICATIONS: fURS using a FANS ureteral access sheath resulted in a high SFS rate with negligible serious adverse event and reintervention rates.PATIENT SUMMARY: We looked at 30-day results for patients undergoing telescopic laser treatment for kidney stones using a special type of vacuum-assisted sheath to remove stone fragments. We found a high stone-free rate with minimal complications.

AB - BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the stone-free status (SFS) rate and complications after flexible ureteroscopy (fURS) for treatment of renal stones using a flexible and navigable suction (FANS) ureteral access sheath.METHODS: Data for adults undergoing fURS in 25 centers worldwide were prospectively collected (August 2023 to January 2024). Exclusion criteria were abnormal renal anatomy and ureteral stones. All patients had computed tomography scans before and within 30 d after fURS with a FANS ureteral access sheath. SFS was defined as follows: grade A, zero fragments; grade B, a single fragment ≤2 mm; grade C, a single fragment 2.1-4 mm; and grade D, single/multiple fragments >4 mm. Data for continuous variables are presented as the median and interquartile range (IQR). Multivariable logistic regression was performed to evaluate predictors of grade A SFS.KEY FINDINGS AND LIMITATIONS: The study enrolled 394 patients (59.1% male) with a median age of 49 yr (IQR 36-61). The median stone volume was 1260 mm3 (IQR 706-1800). Thulium fiber laser (TFL) was used in 45.9% of cases and holmium laser in the rest. The median lasing time was 18 min (IQR 11-28) and the median operative time was 49 min (IQR 37-70). One patient required a blood transfusion and 3.3% of patients had low-grade fever. No patient developed sepsis. Low-grade ureteral injury occurred in eight patients (2%). The grade A SFS rate was 57.4% and the grade A + B SFS rate was 97.2%, while 2.8% of patients had grade C or D SFS. Eleven patients underwent repeat fURS. Multivariable analysis revealed that a stone volume of 1501-3000 mm3 (odds ratio 0.50) and of >3000 mm3 (odds ratio 0.29) were significantly associated with lower probability of grade A SFS, while TFL use was associated with higher SFS probability (odds ratio 1.83). Limitations include the lack of a comparative group.CONCLUSIONS AND CLINICAL IMPLICATIONS: fURS using a FANS ureteral access sheath resulted in a high SFS rate with negligible serious adverse event and reintervention rates.PATIENT SUMMARY: We looked at 30-day results for patients undergoing telescopic laser treatment for kidney stones using a special type of vacuum-assisted sheath to remove stone fragments. We found a high stone-free rate with minimal complications.

KW - Humans

KW - Male

KW - Prospective Studies

KW - Female

KW - Middle Aged

KW - Adult

KW - Ureteroscopy/methods

KW - Kidney Calculi/surgery

KW - Treatment Outcome

KW - Suction/instrumentation

KW - Ureteroscopes

KW - Postoperative Complications/epidemiology

KW - Europe

U2 - 10.1016/j.euf.2024.05.010

DO - 10.1016/j.euf.2024.05.010

M3 - Article

C2 - 38789313

VL - 10

SP - 975

EP - 982

JO - European Urology Focus

JF - European Urology Focus

SN - 2405-4569

IS - 6

ER -

ID: 135981659