The Effect of Ureteral Access Sheath Use/Caliber Change on Outcomes of Retrograde Intrarenal Surgery, Short-Term Kidney Functions, Radiation Exposure, Ureteroscope Lifetime, and Factors Predicting Insertion Failure: A RIRSearch Study

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dc.authorid0000-0003-4154-2052en_US
dc.authorscopusid55753628300en_US
dc.authorwosid-en_US
dc.contributor.authorÖzman, Oktay
dc.contributor.authorAkgül, Murat
dc.contributor.authorBaşaataç, Cem
dc.contributor.authorCakır, Hakan
dc.contributor.authorÇınar, Önder
dc.contributor.authorSancak, Eyüp Burak
dc.date.accessioned2024-02-21T07:48:42Z
dc.date.available2024-02-21T07:48:42Z
dc.date.issued2024en_US
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü
dc.description.abstractBackground: The aim of this study was (1) to explore effect of ureteral access sheath (UAS) use on primary retrograde intrarenal surgery (RIRS) outcomes, short-term kidney functions, radiation exposure, and ureteroscope lifetime (URS-LT) and (2) to reveal factors that predict UAS insertion failure.Materials and Methods: Patients (n = 1318) who underwent RIRS without UAS (Group 1), those who had operation with a <11-13 Fr (Group 2), and those with a >= 11-13 Fr UAS were matched (1:1:2) and compared. Stone-free rate (SFR), intra- and postoperative complications, acute kidney injury (AKI), fluoroscopy time, URS-LT, and UAS insertion failure were the outcomes.Results: SFR, which was highest in Group 3 (75%, 71% and 87.3%, respectively; P = .001), was significantly associated with use of >= 11-13 Fr (odds ratio [OR]: 4.2, P < .001), but was not with use of <11-13 Fr UAS (OR: 1.3, P = .3). Group 3 had less need for auxiliary procedure (15%, 16%, and 7.4%, respectively; P = .03). Five percent of patients had a risk of AKI, but only 0.3% developed AKI. Although UAS use was protective against creatinine increase (OR: 0.65, P = .02), increased risk of AKI waas only associated with female gender (OR: 5.5, P < .001). Fluroscopy times were 5, 15, and 87 sn, respectively (P < .001). Short URS-LT was strongly associated with high frequency of lower calix stones (r = -0.94, P = .005), but URS-LT was not correlated with sheathless case rate (r = 0.59, P = .22). UAS insertion success in first attempt was more likely in younger (OR: 0.99, P = .03), hydronephrotic (OR: 3.4, P < .001), and female cases (OR: 1.5, P = .008). But absolute UAS insertion failure was associated with female gender (OR: 2.7, P = .017).Conclusions: Not any UAS use but a higher caliber UAS use may improve SFR and protect against AKI after RIRS. Although UAS insertion failure is seen mostly in men, it may be more challenging in women owing to less efficacy of preoperative Double-J stent.en_US
dc.identifier.citationÖzman, O., Başataç, C., Akgül, M., Çakır, H., Çınar, Ö., Şimşekoğlu, F., … Önal, B. (2024). The Effect of Ureteral Access Sheath Use/Caliber Change on Outcomes of Retrograde Intrarenal Surgery, Short-Term Kidney Functions, Radiation Exposure, Ureteroscope Lifetime, and Factors Predicting Insertion Failure: A RIRSearch Study. Journal of Laparoendoscopic & Advanced Surgical Techniques, 34(1), 33–38. doi: 10.1089/lap.2023.0358en_US
dc.identifier.doi10.1089/lap.2023.0358
dc.identifier.endpage38en_US
dc.identifier.issn1092-6429
dc.identifier.issn1557-9034
dc.identifier.issue1en_US
dc.identifier.pmid37948549
dc.identifier.scopus2-s2.0-85180461547
dc.identifier.startpage33en_US
dc.identifier.urihttps://doi.org/10.1089/lap.2023.0358
dc.identifier.urihttps://hdl.handle.net/20.500.12428/5739
dc.identifier.volume34en_US
dc.identifier.wosWOS:001138211200001
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorSancak, Eyüp Burak
dc.language.isoen
dc.publisherMary Ann Liebert Inc.en_US
dc.relation.ispartofJournal of Laparoendoscopic and Advanced Surgical Techniquesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectKidney stoneen_US
dc.subjectRetrograde intrarenal surgeryen_US
dc.subjectStone-free rateen_US
dc.subjectUreteral access sheathen_US
dc.titleThe Effect of Ureteral Access Sheath Use/Caliber Change on Outcomes of Retrograde Intrarenal Surgery, Short-Term Kidney Functions, Radiation Exposure, Ureteroscope Lifetime, and Factors Predicting Insertion Failure: A RIRSearch Study
dc.typeArticle

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