TY - JOUR

T1 - Experimental and clinical applications and outcomes of using different forms of suction in retrograde intrarenal surgery. Results from a systematic review

AU - Giulioni, C

AU - Castellani, D

AU - Traxer, O

AU - Gadzhiev, N

AU - Pirola, G M

AU - Tanidir, Y

AU - da Silva, R D

AU - Glover, X

AU - Giusti, G

AU - Proietti, S

AU - Mulawkar, P M

AU - De Stefano, V

AU - Cormio, A

AU - Teoh, J Y-C

AU - Galosi, A B

AU - Somani, B K

AU - Emiliani, E

AU - Gauhar, V

N1 - Copyright © 2023 AEU. Published by Elsevier España, S.L.U. All rights reserved.

PY - 2023/2/24

Y1 - 2023/2/24

N2 - OBJECTIVE: To identify the latest advances in suction devices and evaluate their effect in Retrograde intrarenal surgery (RIRS) and ureteroscopy for stones.BASIC PROCEDURES: A systematic literature search was performed on 4th January 2023 using Scopus, PubMed, and EMBASE. Only English papers were included; both pediatric and adult studies were accepted. Duplicate studies, case reports, letters to the editor, and meeting abstracts were excluded.MAIN FINDINGS: Twenty-one papers were selected. Several methods have been proposed for suction use in RIRS, such as through the ureteral access sheath or directly to the scope. Artificial intelligence can also regulate this system, monitoring pressure and perfusion flow values. All the proposed techniques showed satisfactory perioperative results for operative time, stone-free rate (SFR), and residual fragments. Moreover, the reduction of intrarenal pressure (induced by aspiration) was also associated with a lower infection rate. Even the studies that considered kidney stones with a diameter of 20 mm or higher reported higher SFR and reduced postoperative complications. However, the lack of well-defined settings for suction pressure and fluid flow prevents the standardization of the procedure.CONCLUSION: Aspiration device in the surgical treatment of urinary stones favours a higher SFR, reducing infectious complications, as supported by the included studies. RIRS with a suction system provided to be a natural successor to the traditional technique, regulating intrarenal pressure and aspirating fine dust.

AB - OBJECTIVE: To identify the latest advances in suction devices and evaluate their effect in Retrograde intrarenal surgery (RIRS) and ureteroscopy for stones.BASIC PROCEDURES: A systematic literature search was performed on 4th January 2023 using Scopus, PubMed, and EMBASE. Only English papers were included; both pediatric and adult studies were accepted. Duplicate studies, case reports, letters to the editor, and meeting abstracts were excluded.MAIN FINDINGS: Twenty-one papers were selected. Several methods have been proposed for suction use in RIRS, such as through the ureteral access sheath or directly to the scope. Artificial intelligence can also regulate this system, monitoring pressure and perfusion flow values. All the proposed techniques showed satisfactory perioperative results for operative time, stone-free rate (SFR), and residual fragments. Moreover, the reduction of intrarenal pressure (induced by aspiration) was also associated with a lower infection rate. Even the studies that considered kidney stones with a diameter of 20 mm or higher reported higher SFR and reduced postoperative complications. However, the lack of well-defined settings for suction pressure and fluid flow prevents the standardization of the procedure.CONCLUSION: Aspiration device in the surgical treatment of urinary stones favours a higher SFR, reducing infectious complications, as supported by the included studies. RIRS with a suction system provided to be a natural successor to the traditional technique, regulating intrarenal pressure and aspirating fine dust.

KW - Adult

KW - Humans

KW - Child

KW - Artificial Intelligence

KW - Suction

KW - Treatment Outcome

KW - Kidney Calculi/surgery

KW - Ureter

U2 - https://doi.org/10.1016/j.acuroe.2023.06.001

DO - https://doi.org/10.1016/j.acuroe.2023.06.001

M3 - Review article

C2 - 37302691

VL - 48

SP - 57

EP - 70

JO - Actas Urologicas Espanolas

JF - Actas Urologicas Espanolas

SN - 0210-4806

IS - 1

ER -