Quhal Fahad, Zeng Guohua, Seitz Christian
Department of Urology, Medical University of Vienna, Vienna, Austria.
Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Curr Opin Urol. 2023 Mar 1;33(2):77-83. doi: 10.1097/MOU.0000000000001061. Epub 2022 Nov 7.
To identify the latest advances on the utilization of suctioning devices in the surgical treatment of urinary stones.
Advances are being made to incorporate suction and pressure control capabilities in percutaneous and ureteroscopic lithotripsy. Multiple retrospective studies and few prospective studies have shown that suctioning with minimally invasive percutaneous nephrolithotomy, commonly referred to as Super MiniPerc, can lead to better stone-free rates (SFR) and shorter operative time with lower incidence of infectious complications. Suctioning during retrograde intrarenal surgery (RIRS) has mainly been achieved through suctioning ureteral access sheath. Here as well, the incorporation of suction improved the SFR, but most importantly, reduced the risk of postoperative infectious complications.
Theoretically suction in endourological procedures could facilitate stone debris removal and could reduce intrarenal pressure at the same time allowing for increased irrigation flow potentially decreasing operation time and infectious complications. These claims are supported in contemporary clinical studies, reporting superior SFR and reduced postoperative infectious complications in both percutaneous nephrolithotomy and RIRS.
确定吸引装置在尿路结石手术治疗中的最新应用进展。
经皮肾镜碎石术和输尿管镜碎石术中正在融入吸引和压力控制功能。多项回顾性研究及少量前瞻性研究表明，在微创经皮肾镜取石术（通常称为超微通道经皮肾镜取石术）中进行吸引，可提高结石清除率（SFR），缩短手术时间，并降低感染性并发症的发生率。逆行性肾内手术（RIRS）中的吸引主要通过输尿管鞘进行。同样，在此类手术中加入吸引功能也提高了结石清除率，但最重要的是降低了术后感染性并发症的风险。
理论上，腔内泌尿外科手术中的吸引可促进结石碎片清除，同时降低肾内压力，从而增加冲洗液流量，有可能缩短手术时间并减少感染性并发症。当代临床研究支持了这些说法，报告称在经皮肾镜取石术和逆行性肾内手术中，结石清除率均更高，术后感染性并发症也有所减少。
