Volume 13, Supplement 1
Original Article / Published: April 2025
DOI: https://www.doi.org/10.57045/jemis/1310425.pp25-26
V. Todorova, O. Gatsev, K. Hristov, K. Petkova, D. Petrova, I. Saltirоv
Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria
Abstract
Introduction & Aim: Retrograde intrarenal surgery (RIRS) is a well-established minimally invasive approach for the treatment of kidney stones, particularly those ≤ 1.5 cm. The addition of a flexible and navigable suction ureteral access sheath (FANS) to RIRS has the potential to enhance surgical outcomes by improving irrigation, reducing intrarenal pressure, and facilitating stone fragment clearance. This study aims to evaluate the efficacy and safety of RIRS with the application of FANS for managing kidney stones ≤ 1.5 cm.
Materials and methods: Medical data of 110 patients from January to December 2024 were retrospectively analyzed. All patients underwent RIRS using a flexible ureteroscope and FANS. Data collected included patients` medical history, characteristics of stones, operative time, complications and stone-free rates at the first month.
Findings: Patients‘ mean age was 53.81 ± 11.5 years. Mean hemoglobin level was 128.1 ± 12 g/l, mean serum creatinine – 90,6 ± 13 umol/l. 14,8 % of patients` preoperative results from sterile urine testing were positive for bacteria. Mean stone density from preoperative computer tomography was 1055 ± 70 HU. The choice of FANS length and width was dependent on the patient‘s anatomy and stone location. In 36.7 % of cases, 36 cm was the preferred FANS length, while 63.3 % of the patients had anatomy which suggested using a 46 cm sheath. In 47.7 % of cases 10 Fr sheath was preferred over an 11 Fr (52.3 %). In 96.9 % of cases, there were no intraoperative complications. The most common intraoperative complication was bleeding. The mean surgery duration was 41.7 ± 0.6 minutes. Postoperative complication rates were low – 12 % of patients had postoperative complications such as haematuria, fever or renal colic. Overall, stone stone-free rate in the first month was 96.3 %, leading to less need for additional procedures.
Conclusions: RIRS with the application of FANS is a safe and effective treatment for kidney stones ≤ 1.5 cm. The technique achieves high stone-free rates with minimal complications, providing a viable alternative to more invasive procedures.
References
Keywords:
RIRS, flexible ureteroscopy, FANS, kidney stones
How to cite this article:
V. Todorova, O. Gatsev, K. Hristov, K. Petkova, D. Petrova, I. Saltirоv. Efficacy and safety of RIRS with Application of Flexible and Navigable Suction Ureteral Access Sheath for Kidney Stones Equal or Smaller than 1.5 cm Journal of Endourology and Minimally Invasive Surgery (Bulgaria), 2025; 13(1): 25-26
Corresponding author:
Dr. Viktoria Todorova,
Clinic of Urology
Department of Urology and Nephrology, Military Medical Academy
Address: Sofia 1606, 3, Georgi Sofiyski Blvd.
Email: v.todorova0803@gmail.com