Pre-stenting remains a subject of debate, and its influence on FANS assisted ureteroscopy is unclear. The global FANS collaborative group aims to address the influence of pre-stenting on FANS-assisted ureterorenoscopy (URS).
This prospective multicentre study assesses the outcomes of 394 patients undergoing FANS-assisted ureteroscopy for renal stones. Patients were stratified into a non-pre-stented (group 1, n = 163) and pre-stented group (group 2, n = 231). Data on demographics, stone characteristics, operative parameters, and postoperative 30-day outcomes were analysed. Statistical analyses, including multivariate regression, were performed for stone-free rates (SFR) and complications. SFR was defined by bone window on non-contrast computed tomography (CT).
Pre-stented patients had a higher prevalence of positive urine culture treated with preoperative antibiotics (23.8% vs 12.3%, p = 0.006). Larger stone volumes were noted (1,306 mm3 vs 1,200 mm3, p = 0.027) in group 1. Postoperative complications were minor. Sepsis was not reported in either group. Group 1 had a higher incidence of low-grade Traxer grade 1 ureteric injuries (4.3% vs 0.4%, p = 0.021). FANS resulted in high overall SFRs of 97.5% and 97.0% in groups 1 and group 2. Multivariate analysis showed no statistical difference in SFR between the groups (63.2% vs 53.2%, p = 0.063). Only thulium fibre laser (TFL) and stone volume were significant predictors of residual fragments (RF).
Pre-stenting for FANS is not mandatory irrespective of stone location and volume. The use of TFL and stone volume significantly influenced SFR, while FANS itself proved highly effective in achieving high SFR.
Central European journal of urology. 2024 Nov 28 [Epub]
Victoria Jahrreiss, Vineet Gauhar, Olivier Traxer, Khi Yung Fong, Saeed Bin Hamri, Karl Tan, Vigen Malkhasyan, Satyendra Persaud, Mohamed Elshazly, Wissam Kamal, Steffi Yuen, Vikram Sridharan, Daniele Castellani, Mehmet Ilker Gökce, Nariman Gadzhiev, Deepak Ragoori, Boyke Soebhali, Chu Ann Chai, Azimdjon N Tursunkulov, Yiloren Tanidir, Tzevat Tefik, Anil Shrestha, Marek Zawadzki, Mohamed Amine Lakmichi, Christian Seitz, Bhaskar K Somani
Department of Urology, Medical University of Vienna, Austria., Department of Urology, Ng Teng Fong General Hospital, Singapore., Department of Urology, Hospital Tenon, AP-HP, Sorbonne University, Paris, France., Yong Loo Lin School of Medicine National University of Singapore, Faculty of Medicine, Singapore., King Abdullah International Medical Research Centre, Department of Surgery, Riyadh, Saudi Arabia., Department of Surgery, Section of Urology, Veterans Memorial Medical Centre, Quezon City, Philippines., Urology Unit, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation., Division of Clinical Surgical Sciences, University of the West Indies, St Augustine, Trinidad and Tobago., Urology Unit, Menoufla University, Shibin el Kom, Egypt., Department of Urology, King Fahad Hospital, Jeddah, Saudi Arabia., Department of Surgery, S.H. Ho Urology Centre, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China., Department of Urology, Sree Paduka Speciality Hospital, Thillai Nagar, India., Department of Urology, IRCCS INRCA, Ancona, Italy., Department of Urology, Ankara University School of Medicine, Ankara, Turkey., Department of Urology, Saint-Petersburg State University Hospital, Saint-Petersburg, Russia., Department Urology, Asian Institute of Nephrology and Urology, Hyderabad, India., Department of Urology, Abdul Wahab Sjahranie Hospital Medical Faculty, Muliawarman University, Samarinda, Indonesia., Department of Surgery Urology Unit, University Malaya, Kuala Lumpur, Malaysia., Department of Urology, AkfaMedline Hospital, Tashkent, Uzbekistan., Department of Urology, Marmara University School of Medicine, Istanbul, Turkey., Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey., Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kanti Path, Kathmandu, Nepal., Urology Unit, St. Anna Hospital, Piaseczno, Poland., Department of Urology, Federal University of Paraná, School of Medicine, Department of Urology, Hospital das Clínicas, Curitiba, Brazil., Department of Urology, University Hospital Southampton, United Kingdom.