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Objective <p>To compare the ablation efficacy and efficiency of flexible and navigable suction ureteric access sheath (FANS) and conventional ureteral access sheath (c-UAS) in retrograde intrarenal surgery (RIRS) for kidney stones treatment.</p> Materials and methods <p>A retrospective study of 96 patients who underwent RIRS using thulium fiber laser was performed. We divided the patients into Group 1: FANS and Group 2: c-UAS. We assessed the lithotripsy efficiency (mm<sup>3</sup>/Joules), ablation efficacy (mm<sup>3</sup>/min), and laser energy consumption (Joules/mm<sup>3</sup>). The stone-free rate (SFR) was defined as the absence of stone fragments in a non-contrast abdominal computed tomography 4-weeks after the procedure.</p> Results <p>Both groups presented comparable stone volume (mm<sup>3</sup>) and stone density. RIRS with FANS presented a significantly lower surgical time and laser energy consumption (10.9 vs. 12.1 Joules/mm<sup>3</sup>, <i>p</i> &lt; 0.001). In addition, FANS presented higher ablation efficiency (0.22 vs. 0.09 mm<sup>3</sup>/Joules, <i>p</i> &lt; 0.001) and ablation efficacy (26.1 vs. 19.9 mm<sup>3</sup>/min, <i>p</i> &lt; 0.001). SFR was significantly higher in the FANS group (93.7% vs. 75%, <i>p</i> &lt; 0.001).</p> Conclusion <p>Compared to c-UAS, RIRS with FANS was associated with decreased total operative time and laser energy consumption and presented a significantly higher ablation efficacy and efficiency. Additionally, SFR was significantly higher in the FANS group.</p>

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Is the ablation stone efficacy and efficiency better with a flexible and navigable suction ureteric access sheath?

  • 期刊论文

  • 发表日期：

    2025年4月9日

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  • Luis Rico,
  • Victoria Diaz-Zorita,
  • Leandro Blas,
  • Lorena Banda Ramos,
  • Pablo Sabeh,
  • Pablo Contreras

摘要

Objective

To compare the ablation efficacy and efficiency of flexible and navigable suction ureteric access sheath (FANS) and conventional ureteral access sheath (c-UAS) in retrograde intrarenal surgery (RIRS) for kidney stones treatment.

Materials and methods

A retrospective study of 96 patients who underwent RIRS using thulium fiber laser was performed. We divided the patients into Group 1: FANS and Group 2: c-UAS. We assessed the lithotripsy efficiency (mm3/Joules), ablation efficacy (mm3/min), and laser energy consumption (Joules/mm3). The stone-free rate (SFR) was defined as the absence of stone fragments in a non-contrast abdominal computed tomography 4-weeks after the procedure.

Results

Both groups presented comparable stone volume (mm3) and stone density. RIRS with FANS presented a significantly lower surgical time and laser energy consumption (10.9 vs. 12.1 Joules/mm3, p < 0.001). In addition, FANS presented higher ablation efficiency (0.22 vs. 0.09 mm3/Joules, p < 0.001) and ablation efficacy (26.1 vs. 19.9 mm3/min, p < 0.001). SFR was significantly higher in the FANS group (93.7% vs. 75%, p < 0.001).

Conclusion

Compared to c-UAS, RIRS with FANS was associated with decreased total operative time and laser energy consumption and presented a significantly higher ablation efficacy and efficiency. Additionally, SFR was significantly higher in the FANS group.