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Impact of suction ureteral access sheath in ureteroscopy/retrograde intrarenal surgery: a systematic review and meta-analysis

S. Kayano, A. Matsukawa, E. Laukhtina, Y. Yata, K. Miyajima, M. Murakami, T. Shimomura, SKK. Yuen, SF. Shariat, T. Kimura, T. Yanagisawa

. 2025 ; 14 (5) : 1315-1326. [pub] 20250527

Status not-indexed Language English Country China

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc25014280

BACKGROUND: Advances in technology have led to the introduction of the suction ureteral access sheaths (SUASs) in ureteroscopy (URS) and retrograde intrarenal surgery (RIRS), with their clinical benefits becoming widely acknowledged. We aimed to evaluate the efficacy and safety of using SUASs during URS and RIRS. METHODS: A systematic search was conducted in April 2024 across the MEDLINE, Scopus, and Web of Science databases. Our focus was on studies investigating the use of SUASs during URS/RIRS for urinary stones. To compare the stone-free rate (SFR) and perioperative outcomes between URS/RIRS procedures with and without SUASs, standard pairwise meta-analyses were conducted. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were employed utilizing a random-effects model (PROSPERO: CRD42024538956). RESULTS: Seven studies (n=1,746) were identified. The use of SUASs significantly improved immediate SFR compared to non-SUAS group (RR: 1.23; 95% CI: 1.02 to 1.47; P=0.03), while no significant difference was observed in SFR at one month follow-up. The use of SUASs significantly reduced operation time (MD: -7.98 minutes; 95% CI: -13.46 to -2.50; P=0.004) and overall complication rate (RR: 0.49; 95% CI: 0.34 to 0.71; P<0.001). CONCLUSIONS: Our meta-analyses indicate that the use of SUASs during URS/RIRS significantly improves immediate SFR and offers better perioperative outcomes compared to no use of SUASs. To establish SUASs as standard of care, well-designed randomized controlled trials are needed.

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$a Kayano, Sotaro $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan $u Department of Urology, Subaru Health Insurance Society Ota Memorial Hospital, Gunma, Japan
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$a BACKGROUND: Advances in technology have led to the introduction of the suction ureteral access sheaths (SUASs) in ureteroscopy (URS) and retrograde intrarenal surgery (RIRS), with their clinical benefits becoming widely acknowledged. We aimed to evaluate the efficacy and safety of using SUASs during URS and RIRS. METHODS: A systematic search was conducted in April 2024 across the MEDLINE, Scopus, and Web of Science databases. Our focus was on studies investigating the use of SUASs during URS/RIRS for urinary stones. To compare the stone-free rate (SFR) and perioperative outcomes between URS/RIRS procedures with and without SUASs, standard pairwise meta-analyses were conducted. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were employed utilizing a random-effects model (PROSPERO: CRD42024538956). RESULTS: Seven studies (n=1,746) were identified. The use of SUASs significantly improved immediate SFR compared to non-SUAS group (RR: 1.23; 95% CI: 1.02 to 1.47; P=0.03), while no significant difference was observed in SFR at one month follow-up. The use of SUASs significantly reduced operation time (MD: -7.98 minutes; 95% CI: -13.46 to -2.50; P=0.004) and overall complication rate (RR: 0.49; 95% CI: 0.34 to 0.71; P<0.001). CONCLUSIONS: Our meta-analyses indicate that the use of SUASs during URS/RIRS significantly improves immediate SFR and offers better perioperative outcomes compared to no use of SUASs. To establish SUASs as standard of care, well-designed randomized controlled trials are needed.
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$a Matsukawa, Akihiro $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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$a Laukhtina, Ekaterina $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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$a Yata, Yuji $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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$a Miyajima, Keiichiro $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan $u Department of Urology, Subaru Health Insurance Society Ota Memorial Hospital, Gunma, Japan
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$a Murakami, Masaya $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan $u Department of Urology, Fuji City General Hospital, Shizuoka, Japan
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$a Shimomura, Tatsuya $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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$a Yuen, Steffi Kar Kei $u Department of Urology, The Chinese University of Hong Kong, Hong Kong, China
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$a Shariat, Shahrokh F $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria $u Department of Urology, Semmelweis University, Budapest, Hungary $u Department of Urology, the University of Texas Southwestern Medical Center, Dallas, TX, USA $u Department of Urology, Weill Cornell Medical College, New York, NY, USA $u Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czechia $u Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan $u Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria $u Research Center for Evidence Medicine, Urology Department Tabriz University of Medical Sciences, Tabriz, Iran
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$a Kimura, Takahiro $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
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$a Yanagisawa, Takafumi $u Department of Urology, The Jikei University School of Medicine, Tokyo, Japan $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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