Flexible ureteroscopic lithotripsy with a suctioning ureteral access sheath for removing upper urinary calculi under local anesthesia
ObjectivesWe aimed to probe the safety and effectiveness of flexible ureteroscopic lithotripsy (FURL) with a suctioning ureteral access sheath (S-UAS) for removing upper urinary calculi under local anesthesia (LA).Materials and methodsThe clinical data of 56 patients with upper urinary calculi treat...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-08-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1242981/full |
| _version_ | 1797672342582722560 |
|---|---|
| author | Zhaolin Zhang Song Leng Tianpeng Xie Yuanhu Yuan Xiaoning Wang |
| author_facet | Zhaolin Zhang Song Leng Tianpeng Xie Yuanhu Yuan Xiaoning Wang |
| author_sort | Zhaolin Zhang |
| collection | DOAJ |
| description | ObjectivesWe aimed to probe the safety and effectiveness of flexible ureteroscopic lithotripsy (FURL) with a suctioning ureteral access sheath (S-UAS) for removing upper urinary calculi under local anesthesia (LA).Materials and methodsThe clinical data of 56 patients with upper urinary calculi treated by FURL with an S-UAS under LA during the period between September 2019 and November 2022 were analyzed retrospectively. For LA, intramuscular pethidine (1.0–2.0 mg/kg) and phenergan (25 mg) were administered 30 min prior to surgery, and oxybuprocaine hydrochloride gel was administered through the urethra at the start of the surgery. The S-UAS and flexible ureteroscope were used for FURL. Demographic characteristics, stone-related parameters, and clinical outcomes were analyzed.ResultA total of 66 procedures were performed successfully on 46 patients (Group A), who underwent unilateral surgeries, and on 10 patients (Group B) who underwent same-session bilateral surgeries. All 56 patients were operated upon without altering the anesthesia strategy, and none required additional analgesia. The mean stone sizes of the Group A and Group B patients were 20.24 ± 5.45 mm and 29.40 ± 3.89 mm, respectively. The mean operative times of the two groups were 53.04 ± 13.35 min and 90.00 ± 15.81 min, respectively. In Group A, the stone-free rates (SFRs) were 76.1% (35/46) and 85.1% (40/46) at postoperative day 1 and day 30, respectively. In Group B, the SFRs were 80.0% (16/20) and 85.0% (17/20), respectively. Four (8.7%) patients in Group A suffered complications such as fever, stent pain, urosepsis, and steinstrasse. In Group B, one (10%) patient suffered from fever.ConclusionFURL, combined with an S-UAS under LA, is a feasible option and provides satisfactory clinical outcomes for appropriately selected patients. |
| first_indexed | 2024-03-11T21:28:34Z |
| format | Article |
| id | doaj.art-322aad3b59e441279ff8b3fc2cb5f3fe |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-03-11T21:28:34Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-322aad3b59e441279ff8b3fc2cb5f3fe2023-09-27T12:36:22ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-08-011010.3389/fsurg.2023.12429811242981Flexible ureteroscopic lithotripsy with a suctioning ureteral access sheath for removing upper urinary calculi under local anesthesiaZhaolin Zhang0Song Leng1Tianpeng Xie2Yuanhu Yuan3Xiaoning Wang4Department of Urology, First Affiliated Hospital of Gannan Medical University, Ganzhou, ChinaFirst Clinical Medical College, Gannan Medical University, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Ganzhou, ChinaDepartment of Urology, First Affiliated Hospital of Gannan Medical University, Ganzhou, ChinaObjectivesWe aimed to probe the safety and effectiveness of flexible ureteroscopic lithotripsy (FURL) with a suctioning ureteral access sheath (S-UAS) for removing upper urinary calculi under local anesthesia (LA).Materials and methodsThe clinical data of 56 patients with upper urinary calculi treated by FURL with an S-UAS under LA during the period between September 2019 and November 2022 were analyzed retrospectively. For LA, intramuscular pethidine (1.0–2.0 mg/kg) and phenergan (25 mg) were administered 30 min prior to surgery, and oxybuprocaine hydrochloride gel was administered through the urethra at the start of the surgery. The S-UAS and flexible ureteroscope were used for FURL. Demographic characteristics, stone-related parameters, and clinical outcomes were analyzed.ResultA total of 66 procedures were performed successfully on 46 patients (Group A), who underwent unilateral surgeries, and on 10 patients (Group B) who underwent same-session bilateral surgeries. All 56 patients were operated upon without altering the anesthesia strategy, and none required additional analgesia. The mean stone sizes of the Group A and Group B patients were 20.24 ± 5.45 mm and 29.40 ± 3.89 mm, respectively. The mean operative times of the two groups were 53.04 ± 13.35 min and 90.00 ± 15.81 min, respectively. In Group A, the stone-free rates (SFRs) were 76.1% (35/46) and 85.1% (40/46) at postoperative day 1 and day 30, respectively. In Group B, the SFRs were 80.0% (16/20) and 85.0% (17/20), respectively. Four (8.7%) patients in Group A suffered complications such as fever, stent pain, urosepsis, and steinstrasse. In Group B, one (10%) patient suffered from fever.ConclusionFURL, combined with an S-UAS under LA, is a feasible option and provides satisfactory clinical outcomes for appropriately selected patients.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1242981/fulllocal anesthesiaureteral access sheathflexible ureteroscopic lithotripsyurinary calculistone-free rate |
| spellingShingle | Zhaolin Zhang Song Leng Tianpeng Xie Yuanhu Yuan Xiaoning Wang Flexible ureteroscopic lithotripsy with a suctioning ureteral access sheath for removing upper urinary calculi under local anesthesia Frontiers in Surgery local anesthesia ureteral access sheath flexible ureteroscopic lithotripsy urinary calculi stone-free rate |
| title | Flexible ureteroscopic lithotripsy with a suctioning ureteral access sheath for removing upper urinary calculi under local anesthesia |
| title_full | Flexible ureteroscopic lithotripsy with a suctioning ureteral access sheath for removing upper urinary calculi under local anesthesia |
| title_fullStr | Flexible ureteroscopic lithotripsy with a suctioning ureteral access sheath for removing upper urinary calculi under local anesthesia |
| title_full_unstemmed | Flexible ureteroscopic lithotripsy with a suctioning ureteral access sheath for removing upper urinary calculi under local anesthesia |
| title_short | Flexible ureteroscopic lithotripsy with a suctioning ureteral access sheath for removing upper urinary calculi under local anesthesia |
| title_sort | flexible ureteroscopic lithotripsy with a suctioning ureteral access sheath for removing upper urinary calculi under local anesthesia |
| topic | local anesthesia ureteral access sheath flexible ureteroscopic lithotripsy urinary calculi stone-free rate |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1242981/full |
| work_keys_str_mv | AT zhaolinzhang flexibleureteroscopiclithotripsywithasuctioningureteralaccesssheathforremovingupperurinarycalculiunderlocalanesthesia AT songleng flexibleureteroscopiclithotripsywithasuctioningureteralaccesssheathforremovingupperurinarycalculiunderlocalanesthesia AT tianpengxie flexibleureteroscopiclithotripsywithasuctioningureteralaccesssheathforremovingupperurinarycalculiunderlocalanesthesia AT yuanhuyuan flexibleureteroscopiclithotripsywithasuctioningureteralaccesssheathforremovingupperurinarycalculiunderlocalanesthesia AT xiaoningwang flexibleureteroscopiclithotripsywithasuctioningureteralaccesssheathforremovingupperurinarycalculiunderlocalanesthesia |