Objectives: To compare the oncological outcomes of patients with upper tract urothelial carcinoma (UTUC) undergoing kidney-sparing surgery (KSS) with fibre-optic (FO) vs digital (D) ureteroscopy (URS). To evaluate the oncological impact of image-enhancement technologies such as narrow-band imaging (NBI) and Image1-S in patients with UTUC.
Patients And Methods: The Clinical Research Office of the Endourology Society (CROES)-UTUC registry is an international, multicentre, cohort study prospectively collecting data on patients with UTUC. Patients undergoing flexible FO- or D-URS for diagnostic or diagnostic and treatment purposes were included. Differences between groups in terms of overall survival (OS) and disease-free survival (DFS) were evaluated.
Results: The CROES registry included 2380 patients from 101 centres and 37 countries, of whom 401 patients underwent URS (FO-URS 186 and D-URS 215). FO-URS were performed more frequently for diagnostic purposes, while D-URS was peformed when a combined diagnostic and treatment strategy was planned. Intra- and postoperative complications did not differ between the groups. The 5-year OS and DFS rates were 91.5% and 66.4%, respectively. The mean OS was 42 months for patients receiving FO-URS and 39 months for those undergoing D-URS (P = 0.9); the mean DFS was 28 months in the FO-URS group and 21 months in the D-URS group (P < 0.001). In patients who received URS with treatment purposes, there were no differences in OS (P = 0.9) and DFS (P = 0.7). NBI and Image1-S technologies did not improve OS or DFS over D-URS.
Conclusions: D-URS did not provide any oncological advantage over FO-URS. Similarly, no differences in terms of OS and DFS were found when image-enhancement technologies were compared to D-URS. These findings underline the importance of surgeon skills and experience, and reinforce the need for the centralisation of UTUC care.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9292011 | PMC |
| http://dx.doi.org/10.1111/bju.15494 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Innovative use of the new pulsed-thulium: YAG laser for ureteroscopic lithotripsy: can the "kidney stone calculator" predict lithotripsy duration?
Urolithiasis
December 2024
Groupe de Recherche Clinique sur la Lithiase Urinaire, GRC n°20, Hôpital Tenon, Sorbonne Université, Paris, 75020, France.
To assess the accuracy of Kidney Stone Calculator(KSC), a software designed for surgical planning, in predicting the duration of lithotripsy during flexible ureteroscopy(FURS) when using the novel pulsed-Thulium: YAG(p-Tm: YAG) laser. From February to August 2023, a single-center prospective study was conducted, including patients with kidney or ureteral stones through non-contrast computed tomography(NCCT), who underwent FURS with p-Tm: YAG laser lithotripsy. KSC used three-dimensional segmentation of the stones from NCCT images, along with an interactive user interface for laser settings, to estimate the stone volume(SV) and the lithotripsy duration(LD).
View Article and Find Full Text PDFFirst use and evaluation of a novel 6.3 Fr disposable flexible ureteroscope for stone management in duplex kidney: a case report.
Transl Androl Urol
November 2024
Department of Urology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China.
Background: Flexible ureteroscopy (FURS) is increasingly used as the first-line treatment for urological procedures. Disposable digital (dd-)FURS has been developed to overcome limitations such as durability, degradation, and repair cost of reusable scopes. The diameter of commercially-available models ranges from 7.
View Article and Find Full Text PDFPressure reduction and suction characteristics of the new digital single use flexible ureteroscope with suction: an in-vitro experimental study.
World J Urol
November 2024
Department of Urology, University of Patras, Patras, Greece.
Purpose: To assess the time taken by the single use 7.5Fr suction flexible ureteroscope to reduce pressure under 40 mm Hg and to characterize the behavior of stones, fragments and dust during suction activation.
Methods: An in vitro setting was developed for this experiment.
Novel scoring system for predicting stone-free rate after flexible ureteroscopy lithotripsy.
Medicine (Baltimore)
November 2024
Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, China.
This study aims to investigate the factors affecting the stone-free rate (SFR) of flexible ureteroscopy and laser lithotripsy (fURSL) for renal stones and establish predictive models by identifying their prognostic factors. We retrospectively examined 252 patients with renal stones who were treated with fURSL between July 2020 and April 2022. We analyzed the relationship between the patient's clinical data (sex, age, and body mass index), stone status (side, size, location, stone/transverse process pixel ratio [STPR], and the CT value of stone [SCTV]), and SFR to determine the relevant factors and analyze their influence.
View Article and Find Full Text PDFDigital Flexible Ureteroscope: Evaluating Factors Responsible for Damage and Implementing a Mandatory Certification Program for Usage.
J Endourol
December 2024
Miller School of Medicine, Desai Sethi Urology Institute, University of Miami, Miami, Florida, USA.
Digital flexible ureteroscopes (DFUs) play a crucial role in endourological procedures, and scope breakages are often avoidable with proper measures in place. We aimed to evaluate the effect of mandatory training on DFU durability and to assess the influence of various factors on instrument damage. Mandatory training involving instructional videos on DFU care was introduced for all processing and operating room staff handling DFUs.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!