Comparing Ureteral Access Sheath and Percutaneous Nephrostomy in Ureteroscopy
Author Information
Author(s): Alhefnawy Mohamed Abdelrahman, Abdelrahman Moaz Fathy Ismail, Abo-Elnasr Hosam Abdel-fattah, Eldib Helmy Ahmed
Primary Institution: Benha University
Hypothesis
Ultrasound guided PCN insertion in lower calyx before flexible ureteroscopy will provide benefits similar to UAS in terms of stone free rate and reduced intra-renal pressure.
Conclusion
PCN insertion before flexible ureteroscopy is a safe technique with comparable outcomes to UAS use, showing a higher success rate and fewer complications.
Supporting Evidence
- PCN group showed a higher stone-free rate compared to UAS group (96% vs. 90%).
- Operative time was significantly shorter in the PCN group (48.85 min) compared to the UAS group (56.82 min).
- Bleeding complications were lower in the PCN group (6%) compared to the UAS group (22%).
- PCN insertion did not significantly increase the risk of postoperative complications.
Takeaway
This study looked at two ways to help remove kidney stones. One method uses a special tube, and the other uses a different kind of tube that goes into the kidney first. The study found that both methods work well, but the second method might be safer and faster.
Methodology
A prospective randomized study comparing PCN and UAS in 100 patients with upper ureteric stones, assessing safety, efficacy, and perioperative outcomes.
Potential Biases
The male-to-female ratio in the UAS group may introduce bias in bleeding outcomes.
Limitations
Different surgeons' experiences were not evaluated, and the sample size may not fully represent the population.
Participant Demographics
Patients aged 20 to 67 years, with 52% male in the PCN group and 66% male in the UAS group.
Statistical Information
P-Value
0.0003
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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