Alkhamees Mohammad, Aljuhayman Ahmed, Addar Abdulmalik, Ghazwani Yahya, Alasker Ahmed, Hamri Saeed Bin
Department of Urology, College of Medicine, Majmaah University, Al Majma'ah, Saudi Arabia.
Division of Urology, Department of Surgery, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.
Urol Ann. 2020 Oct-Dec;12(4):331-334. doi: 10.4103/UA.UA_94_20. Epub 2020 Aug 10.
The objective of the study was to identify the failure rate of insertion of ureteral access sheath (UAS) during primary flexible ureteroscopy (FURS).
This was a single-surgeon, single-tertiary care center retrospective study. All patients who underwent primary FURS for proximal ureteric or renal stones from November 2014 to May 2018 were included in the study. Patients with a stone burden of more than 20 mm were excluded from the study. A 10/12-Fr coaxial UAS (Bi-Flex, Rocamed) was used. Data collection included age, sex, body mass index (BMI), stone burden and location, previous spontaneous passage of stones, type of anesthesia, and preexisting congenital anomalies. The Chi-square test and -test were used for the statistical analyses.
One hundred and twelve patients were included in the study. All patients underwent primary FURS. The failure rate of primary UAS insertion was 10.7% ( = 12). No statistically significant difference was found in age, BMI, type of anesthesia, previous history of spontaneous stone passage, and stone burden between the success and failure groups ( > 0.05).
We believe that our study opens the door for a multicentric prospective trial. Identifying factors leading to a failed primary FURS and UAS insertion is crucial to properly counsel patients preoperatively about the number of procedures that they might need and to prevent the financial loss associated with failed UAS insertion.
本研究的目的是确定在初次软性输尿管镜检查（FURS）期间输尿管通路鞘（UAS）置入的失败率。
这是一项单中心、单外科医生的回顾性研究。纳入了2014年11月至2018年5月期间因近端输尿管结石或肾结石接受初次FURS的所有患者。结石负荷超过20mm的患者被排除在研究之外。使用了10/12Fr同轴UAS（Bi-Flex，Rocamed）。数据收集包括年龄、性别、体重指数（BMI）、结石负荷和位置、既往结石自然排出情况、麻醉类型以及既往先天性异常。采用卡方检验和t检验进行统计分析。
112例患者纳入研究。所有患者均接受了初次FURS。初次UAS置入的失败率为10.7%（n = 12）。成功组和失败组在年龄、BMI、麻醉类型、既往结石自然排出史和结石负荷方面未发现统计学显著差异（P > 0.05）。
我们认为我们的研究为多中心前瞻性试验打开了大门。识别导致初次FURS和UAS置入失败的因素对于术前正确告知患者他们可能需要的手术次数以及防止与UAS置入失败相关的经济损失至关重要。
