PMID- 38546503
OWN - NLM
STAT- Publisher
LR  - 20240328
IS  - 1557-9034 (Electronic)
IS  - 1092-6429 (Linking)
DP  - 2024 Mar 28
TI  - Efficacy of Aspiration-Assisted Ureteral Access Sheath (ClearPETRA) in Retrograde 
      Intrarenal Surgery.
LID - 10.1089/lap.2024.0076 [doi]
AB  - Backgrounds: In the renal intrarenal stone surgery (RIRS) procedure, ureteral 
      access sheath (UAS) is still used in the majority of surgeries to both protect 
      the flexible ureteroscope (FURS) and reduce intrarenal pressure. ClearPETRA is a 
      new UAS that has an integrated aspiration port. We aimed to evaluate the clinical 
      outcomes and effectiveness of Aspiration-Assisted UAS (ClearPETRA) in the RIRS 
      procedure. Methods: One thousand six hundred twenty patients who underwent RIRS 
      between January 2021 and January 2024 were evaluated retrospectively and 512 
      patients were included in the study. According to stone size, patients with 
      stones less than 2 cm and those with stones between 2 and 3 cm were analyzed 
      separately. Patient's demographic data, stone size, body mass index, 
      Extracoporeal Shockwave Lithotripsy (ESWL) history, stone side, stone density 
      (Hounsfield Unit), operation time, stone-free rate (SFR), and the number of 
      patients with sepsis were recorded. SFR was evaluated with kidney urinary bladder 
      3 months after surgery for opaque calculi. Nonopaque calculi patients were 
      evaluated with noncontrast computed tomography 3 months after surgery. In the 
      postoperative evaluation, patients with stones less than 4 mm were evaluated as 
      SFR. P value of <0.01 was considered statistically significant. Results: 
      Patient's demographic data, stone characteristics, and history of ESWL were 
      similar in the ClearPETRA and UAS groups (P > .05). A total of 328 patients who 
      underwent RIRS for stones less than 2 cm were included (80 ClearPETRA, 248 UAS). 
      Length of hospital stay, operation time, SFR, secondary intervention, or 
      postoperative sepsis (P >/= .01) were similar in both groups. The incidence of 
      postoperative fever was statistically significantly lower in the ClearPETRA group 
      (P = .006). A total of 184 patients who underwent RIRS for stones between 2 and 
      3 cm were included (42 ClearPETRA, 142 UAS). In the ClearPETRA group, operation 
      time was statistically significantly shorter (P = .002), SFR was statistically 
      significantly higher (P = .003), and the number of fever and sepsis were 
      statistically significantly less (P = .003 and 0.002, respectively). Conclusion: 
      We found that ClearPETRA reduces the likelihood of postoperative fever after RIRS 
      surgeries. Moreover, we can say that the use of ClearPETRA in RIRS, especially 
      for stones larger than 2 cm, reduces the operation time, increases the SFR, and 
      also reduces sepsis rates.
FAU - Erkoc, Mustafa
AU  - Erkoc M
AUID- ORCID: 0000-0003-0679-2873
AD  - Department of Urology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
FAU - Bozkurt, Muammer
AU  - Bozkurt M
AUID- ORCID: 0000-0001-9011-7293
AD  - Department of Urology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
FAU - Sezgin, Mehmet Ali
AU  - Sezgin MA
AD  - Department of Urology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
FAU - Ozcan, Levent
AU  - Ozcan L
AD  - Department of Urology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
FAU - Can, Osman
AU  - Can O
AUID- ORCID: 0000-0003-1329-6034
AD  - Department of Urology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
FAU - Danis, Eyyup
AU  - Danis E
AD  - Department of Urology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
FAU - Polat, Emre Can
AU  - Polat EC
AUID- ORCID: 0000-0001-5254-2563
AD  - Department of Urology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
FAU - Otunctemur, Alper
AU  - Otunctemur A
AD  - Department of Urology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20240328
PL  - United States
TA  - J Laparoendosc Adv Surg Tech A
JT  - Journal of laparoendoscopic & advanced surgical techniques. Part A
JID - 9706293
SB  - IM
OTO - NOTNLM
OT  - intrarenal pressure
OT  - retrograde intrarenal surgery
OT  - vacuum-assisted ureteral access sheath
EDAT- 2024/03/28 12:46
MHDA- 2024/03/28 12:46
CRDT- 2024/03/28 11:03
PHST- 2024/03/28 12:46 [medline]
PHST- 2024/03/28 12:46 [pubmed]
PHST- 2024/03/28 11:03 [entrez]
AID - 10.1089/lap.2024.0076 [doi]
PST - aheadofprint
SO  - J Laparoendosc Adv Surg Tech A. 2024 Mar 28. doi: 10.1089/lap.2024.0076.