From the Department of Urology, Faculty of MEdicine, Yozgat Bozok University, Yozgat, Turkey.
From the Deparment of Urology, Faculty of Medicine, Istabbul Medeniyet University, Istanbul, Turkey.
Ann Saudi Med. 2020 Sep-Oct;40(5):382-388. doi: 10.5144/0256-4947.2020.382. Epub 2020 Oct 1.
Retrograde intrarenal surgery is used for treatment of urinary system stones. The ureteral access sheath (UAS) is used to decrease intrapelvic pressure, help with access of multiple instruments, and facilitate drainage and removal of the fragmented stones.
Assess the effect of the UAS on the outcomes of retrograde intrarenal surgery.
A retrospective patient data review.
Training and research hospital in Turkey.
We reviewed the data of patients who had undergone retrograde intrarenal surgery between 2012-2019. Patients who had kidney anomalies, were <18 years old, and who had ureteral and urethral strictures were excluded from the study. The demographic characteristics, stone type, complications, intraoperative and postoperative data of the patients were reviewed. A successful outcome was defined as being stone free or having clinically insignificant residual fragments (<3 mm). The use of the UAS was compared with other procedures in terms of efficiency and safety. Factors determining UAS usage were assessed by multivariate analysis.
Stone free rate and complication rate in patients who underwent retrograde intrarenal surgery.
1808 patients met inclusion criteria.
The UAS was used in 1489 procedures, while other methods were used in 319 procedures. Operation time was 46.9 (17.3) minutes and 42.9 (19.0) minutes with other methods. Postoperative double J stent usage rates were 88.2% and 63% in the UAS and other methods, respectively. The rate of successful outcome was 88.2% and 81.2% in the UAS and other methods, respectively (<.001). The rate of complications was similar in both groups (=.543). In a multivariate analysis, UAS usage was directly proportional with stone size and inversely proportional with preoperative JJ stent usage CONCLUSION: The UAS can be effectively and successfully used in retrograde intrarenal surgery for treatment of urinary system stones. UAS usage should be considered for the patients who have large stones (2 cm) and do not have a preoperative double J stent.
Retrospective design.
None.
逆行肾盂内手术用于治疗泌尿系统结石。输尿管.access 鞘（UAS）用于降低肾盂内压力，帮助多种器械进入，以及促进结石的引流和清除。
评估 UAS 对逆行肾盂内手术结果的影响。
回顾性患者数据回顾。
土耳其的一家培训和研究医院。
我们回顾了 2012-2019 年间接受逆行肾盂内手术的患者的数据。排除患有肾脏异常、年龄<18 岁以及患有输尿管和尿道狭窄的患者。回顾了患者的人口统计学特征、结石类型、并发症、术中及术后数据。成功的结果定义为无结石或有临床意义的残留碎片（<3 毫米）。通过比较效率和安全性来比较 UAS 的使用与其他程序。通过多变量分析评估确定 UAS 使用的因素。
接受逆行肾盂内手术患者的无结石率和并发症率。
符合纳入标准的患者为 1808 例。
UAS 用于 1489 例手术，而其他方法用于 319 例手术。手术时间分别为 46.9（17.3）分钟和 42.9（19.0）分钟。UAS 和其他方法术后双 J 支架使用率分别为 88.2%和 63%。UAS 和其他方法的成功率分别为 88.2%和 81.2%（<.001）。两组并发症发生率相似（=.543）。在多变量分析中，UAS 的使用与结石大小成正比，与术前 JJ 支架的使用成反比。
UAS 可有效、成功地用于逆行肾盂内手术治疗泌尿系统结石。对于有大结石（2cm）且无术前双 J 支架的患者，应考虑使用 UAS。
回顾性设计。
无。
