输尿管通达鞘及其临床应用

The ureteral access sheath and its clinical practice in flexible ureteroscopy

置放输尿管通达鞘(UAS)是软性输尿管镜术的重要步骤。UAS从最初临床应用到现在已有不断改进,现已有各种不同特点、直径和长度的UAS,拥有全新的亲水涂层设计以及抗弯曲与打折的加固金属层UAS。软镜术中应用UAS有许多优点,它能够提高液体灌流量并降低肾盂内压、提高视野清晰度、缩短手术时间与成本、提高软镜手术的效率、延长软镜的使用寿命等。然而,放置UAS也有增加输尿管缺血和导致输尿管狭窄等并发症的风险。本文就UAS及其临床应用现状进行综述。

The ureteral access sheath(UAS),as an important part of flexible ureteroscopy,is widely used recently in endourology from the first clinical application to the later process of continuous improvement.The UAS,with a variety of different brands,features,diameters and lengths available,has been designed with a hydrophilic coating and reinforced with impregnated coils resistant to kinking and buckling.The application of UAS has advantages of increasing the flow of irrigation fluid and reducing the intrapelvic pressure,raising visualization and decreasing costs and operative time,thus improving effectiveness of the surgery,as well as protecting ureteroscopes to prolong the longevity of them.However,deployment of the UAS may increase the risk of ischemic injury and ureteral stenosis.This paper will conduct a literature review to assess the status on the application of the UAS from current literatures available.