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You have accessJournal of UrologyStone Disease: Surgical Therapy (including ESWL) II (PD10)1 May 2024PD10-09 24 HOURS AFTER RETROGRADE INTRARENAL SURGERY FOR SOLITARY RENAL CALCULI USING A FLEXIBLE AND NAVIGABLE SUCTION ACCESS SHEATH (FANS) : RESULTS FROM A PROSPECTIVE GLOBAL MULTICENTRE STUDY BY THE EAU SECTION ON UROLITHIASIS (EULIS) Mohamed Amine Lakmichi, Olivier Traxer, Bhaskar K. Somani, Christian Seitz, Khi Yung Fong, Daniele Castellani, Ben H. Chew, and Vineet Gauhar Mohamed Amine LakmichiMohamed Amine Lakmichi , Olivier TraxerOlivier Traxer , Bhaskar K. SomaniBhaskar K. Somani , Christian SeitzChristian Seitz , Khi Yung FongKhi Yung Fong , Daniele CastellaniDaniele Castellani , Ben H. ChewBen H. Chew , and Vineet GauharVineet Gauhar View All Author Informationhttps://doi.org/10.1097/01.JU.0001008748.59024.cb.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Suction techniques are revolutionising flexible ureteroscopy.Primary aim: Evaluate intra and peri operative stone free rate (SFR) and complications in first 24hrs after RIRS for solitary renal stones in normal renal anatomy using Flexible And Navigable Suction access sheath (FANS) in a global multicentre study .Secondary aim: To assess utility and challenges encountered. METHODS: Proposed by EULIS ureteroscopy committee, prospective data gathered from 15 countries. Ethical approval for annonymised IRB registry obtained by Asian Institute of Nephrology and Urology, Hyderabad ( #AINU 12/2022). Inclusion criteria:Adult with solitary renal stone and normal anatomy undergoing RIRS using FANS. Data recorded for baseline and operative characteristics .A non- contrast CT scan within 24 hours to document as a proof of concept study, reported SFR, intra and immediate postoperative complications and exit strategy.UVA, MVA performed for 100% SFR, expressed as ORs and 95% CI. RESULTS: 142 cases, median stone volume of 1165 mm3. Preferentially11/13 Ffr (44.4%) FANS with a disposable scope (77.5%) under general anaesthesia (80.3%), used in 86.6% cases.TFL most commonly used .Only 15.5% cases needed stone fragments repositioning with basket.Mean laser, total ureteroscopy time (the time scope and sheath were handled together in pcs) and overall operative times were was 16.5, 35.5 and 48.5 min respectively. In 84.5% cases, DJ stent and in 9.2% and 6.3% patients an overnight ureteric catheter or no drainage respectively. In the latter, a change from their routine exit strategy was reported by the surgeon in 12.7% cases 46.5% cases reported visual complete clearance confirmed by 24Hr NCCT. Complication were low, CD 1 and II, fever (7%), ureteric injury grade I (n=4), grade II (n=1) needed stenting. No sepsis. Overall SFR was 96.5%. Reintervention planned In 4 off 5 patients with fragments >4 mm. CONCLUSIONS: For the first time utilising a CT scan 24-hrs post RIRS with FANS, as proof of concept we document how FANS achieved a high immediate single stage SFR with minimal iatrogenic and infective complications by safely navigating the PCS and effectively using suction to extract fragments and dust in a global multicentre prospective study. This minimised use of baskets and unnecessary stenting. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e189 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mohamed Amine Lakmichi More articles by this author Olivier Traxer More articles by this author Bhaskar K. Somani More articles by this author Christian Seitz More articles by this author Khi Yung Fong More articles by this author Daniele Castellani More articles by this author Ben H. Chew More articles by this author Vineet Gauhar More articles by this author Expand All Advertisement PDF downloadLoading ...
Lakmichi et al. (Mon,) studied this question.