{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:26:01Z","timestamp":1792005961001,"version":"4.4.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T00:00:00Z","timestamp":1693440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to probe the safety and effectiveness of flexible ureteroscopic lithotripsy (FURL) with a suctioning ureteral access sheath (S-UAS) for removing upper urinary calculi under local anesthesia (LA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>The clinical data of 56 patients with upper urinary calculi treated by FURL with an S-UAS under LA during the period between September 2019 and November 2022 were analyzed retrospectively. For LA, intramuscular pethidine (1.0\u20132.0\u2005mg\/kg) and phenergan (25\u2005mg) were administered 30\u2005min prior to surgery, and oxybuprocaine hydrochloride gel was administered through the urethra at the start of the surgery. The S-UAS and flexible ureteroscope were used for FURL. Demographic characteristics, stone-related parameters, and clinical outcomes were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>A total of 66 procedures were performed successfully on 46 patients (Group A), who underwent unilateral surgeries, and on 10 patients (Group B) who underwent same-session bilateral surgeries. All 56 patients were operated upon without altering the anesthesia strategy, and none required additional analgesia. The mean stone sizes of the Group A and Group B patients were 20.24\u2009\u00b1\u20095.45\u2005mm and 29.40\u2009\u00b1\u20093.89\u2005mm, respectively. The mean operative times of the two groups were 53.04\u2009\u00b1\u200913.35\u2005min and 90.00\u2009\u00b1\u200915.81\u2005min, respectively. In Group A, the stone-free rates (SFRs) were 76.1% (35\/46) and 85.1% (40\/46) at postoperative day 1 and day 30, respectively. In Group B, the SFRs were 80.0% (16\/20) and 85.0% (17\/20), respectively. Four (8.7%) patients in Group A suffered complications such as fever, stent pain, urosepsis, and steinstrasse. In Group B, one (10%) patient suffered from fever.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>FURL, combined with an S-UAS under LA, is a feasible option and provides satisfactory clinical outcomes for appropriately selected patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2023.1242981","type":"journal-article","created":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T09:08:02Z","timestamp":1693472882000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Flexible ureteroscopic lithotripsy with a suctioning ureteral access sheath for removing upper urinary calculi under local 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