The Effectiveness and Safety of a Flexible Vacuum-Assisted Ureteral Access Sheath in Flexible Ureteroscopic Lithotripsy

Abstract

Abstract Objective: To investigate the efficacy and safety of a flexible vacuum-assisted ureteral access sheath (FV-UAS) in flexible ureteroscopic lithotripsy. Methods: We collected data on procedures using a traditional ureteralaccess sheath (UAS) from May to November 2022 and those using a FV-UAS from December 2022 to June 2023 and conducted a retrospective analysis of the two groups of data. SIRS incidence, stone clearance rate and operation time were the main evaluation criteria. Age composition, sex, preoperative urinary leukocyte count, underlying disease, stone density and stone volume were used as secondary evaluation indices. Results: There was no significant difference in age composition, sex, preoperative urinary leukocyte count, underlying diseases, stone density or stone volume between the two groups (P>0.05). The operation time of the UAS group (57.90±17.86) was higher than that of the FV-UAS group (48.40±15.89, P<0.05). The incidence of SIRS was lower in the FV-UAS (1.70% vs. 12.9%, P<0.05). The stone-free rate in both the UAS group and the FV-UAS group at 3 days after surgery was similar (20.97% vs. 20.33%, P>0.05), while the stone-free rate was 85.48% and 96.60% at 1 month after surgery (P<0.05), and the difference wasstatistically significant, especially the absolute stone-free rate (P<0.01)。 Conclusion: Compared with the UAS, the FV-UAS can reduce the incidence of SIRS postoperatively as well as shorten the operation time and improve the stone-free rate of flexible ureteroscopic lithotripsy.