Buscar en
Actas Urológicas Españolas (English Edition)
Toda la web
Inicio Actas Urológicas Españolas (English Edition) Ureteral access sheath-related injuries vs. post-operative infections. Is sheath...
Journal Information
Vol. 45. Issue 9.
Pages 576-581 (November 2021)
Share
Share
Download PDF
More article options
ePub
Visits
22
Vol. 45. Issue 9.
Pages 576-581 (November 2021)
Original article
Ureteral access sheath-related injuries vs. post-operative infections. Is sheath insertion always needed? A prospective randomized study to understand the lights and shadows of this practice
Lesiones relacionadas con la vaina de acceso ureteral frente a infecciones postoperatorias. ¿Es siempre necesaria la inserción de la vaina de acceso? Estudio prospectivo aleatorizado para comprender las luces y sombras de esta práctica
Visits
...
G. Bozzinia,b,
Corresponding author
gioboz@yahoo.it

Corresponding author.
, L. Bevilacquac, U. Besanab, A. Calorib, A. Pastored, J. Romero Oteroe, A. Macchif, P. Brogginib, A. Bredaa,g, A. Gozena,h, R. Inzilloc, S. Puliattic, M.C. Sighinolfic, B. Roccoa,c, E. Liatsikosa,i, A. Mullerj, C. Buizzab
a ESUT, European Section for UroTechnology EAU, Arnhem, The Netherlands
b Urology Department, ASST Valle Olona, Busto Arsizio, Lombardía, Italy
c Urology Department, Baggiovara Hospital, Módena, Italy
d Urology Department, Università La Sapienza, Latina, Italy
e Urology Department, Hospital 12 de Octubre, Madrid, Spain
f Urology Department, INT, Milán, Italy
g Urology Department, Fundacio Puigvert, Barcelona, Spain
h Urology Department, University of Heidelberg, Heilbronn, Germany
i Urology Department, University of Patras, Patras, Greece
j Urology Department, Limattal Hospital, Schilieren, Switzerland
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (3)
Table 1. Patients data.
Table 2. PULS Scale Ureteral Lesions.
Table 3. Postoperative infections.
Show moreShow less
Abstract
Objective

To compare intraoperative ureteral injuries in RIRS with UAS insertion with the rate of postoperative infections after RIRS without UAS insertion.

Patients and methods

In this randomized trial, patients who received an indication for RIRS between January 2017 and December 2017 were divided into two groups. Group A had no UAS insertion and Group B had UAS insertion. Post-Ureteroscopic Lesion Scale (PULS) grading was performed after UAS or flexible ureteroscope removal. Proximal, middle and distal ureteral lesions were evaluated and compared according to the PULS scale. Additionally, patients in both groups were followed postoperatively to assess any infective complication.

Results

The evaluation comprised 181 patients, 89 for group A and 92 for group B. Overall stone-free rate, clinically insignificant residual fragments, and final stone-free rate were 41.4%, 53.5%, and 95%, respectively. There were 33 (37.1%) patients with ureteral lesions in group A while 42 (45.6%) patients had ureteral lesions in group B, with no significant difference. On the other hand, the overall presence of postoperative infection rate was much higher for Group A (37.1% vs 16.3% P = 0.03).

Conclusions

UAS insertion does not result in a higher number of ureteral injuries. UAS insertion during RIRS allows a lower rate of postoperative infections.

Clinical Trial Registration Number (ISRCTN registry number)

55546280.

Keywords:
Retrograde intrarenal surgery
Ureteral access sheath
Ureteral injuries
Infection
Ureteroscopy
Resumen
Objetivo

Comparar las lesiones ureterales intraoperatorias ocasionadas durante la CRIR con inserción de VAU con la tasa de infecciones postoperatorias tras la CRIR sin inserción de VAU.

Pacientes y métodos

En este ensayo aleatorizado los pacientes que recibieron una indicación de una CRIR entre enero de 2017 y diciembre de 2017 se dividieron en 2 grupos. En el grupo A no se utilizó VAU y en el grupo B sí se utilizó VAU. Se realizó la clasificación de la escala Post-Ureteroscopic Lesion Scale (PULS) tras retirar la VAU o el ureteroscopio flexible. Las lesiones del uréter proximal, medio y distal se evaluaron y compararon según la escala PULS. Además, los pacientes de ambos grupos recibieron seguimiento postoperatorio para evaluar el desarrollo de cualquier enfermedad infecciosa.

Resultados

El estudio incluyó a 181 pacientes, 89 del grupo A y 92 del grupo B. La tasa de ausencia de cálculos global, los fragmentos residuales clínicamente insignificantes y la tasa de ausencia de cálculos final fueron del 41,4%, 53,5% y 95%, respectivamente. Hubo 33 (37,1%) pacientes con lesiones ureterales en el grupo A y 42 (45,6%) pacientes con lesiones ureterales en el grupo B, sin diferencias estadísticamente significativas. Por otra parte, la tasa de infección postoperatoria fue mucho mayor en el grupo A (37,1% frente a 16,3% p = 0,03).

Conclusiones

No se ha visto un mayor número de lesiones ureterales tras la inserción de la VAU. La inserción de una VAU durante la CRIR resulta en una tasa menor de infecciones postoperatorias.

Número de registro del ensayo clínico (número de registro ISRCTN)

55546280.

Palabras clave:
Cirugía retrógrada intrarrenal
Vaina de acceso ureteral
Lesiones ureterales
Infección
Ureteroscopia

Article

These are the options to access the full texts of the publication Actas Urológicas Españolas (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Actas Urológicas Españolas (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos