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Erschienen in: World Journal of Urology 11/2019

15.02.2019 | Topic Paper

Which flexible ureteroscope is the best for upper tract urothelial carcinoma treatment?

verfasst von: Etienne Xavier Keller, Steeve Doizi, Luca Villa, Olivier Traxer

Erschienen in: World Journal of Urology | Ausgabe 11/2019

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Abstract

Purpose

To present attributes of currently available flexible ureteroscopes to define the best flexible ureteroscope for upper tract urothelial carcinoma (UTUC) treatment.

Materials and methods

Scopus and Medline databases were searched for articles relating to performance of flexible ureteroscopes. A consensus for final inclusion of articles judged to be relevant for UTUC treatment was reached between the authors. Instrument characteristics were extracted from manufacturers’ product brochures.

Results

Smaller cross-sectional size of instruments is associated with increased probability for successful primary access to the upper urinary tract. The smallest flexible ureteroscopes are fiberoptic scopes. Smaller ureteroscopes also allow comparatively increased irrigation flow at constant intrarenal pressure. Digital flexible ureteroscopes achieve superior image quality compared to their fiberoptic counterparts, at the price of lower end-deflection ability. Image enhancement technologies such as narrow-band imaging (NBI), photodynamic diagnosis (PDD) and Image 1-S (formerly SPIES) are based on subjective image interpretation by the operator. NBI and PDD significantly increase tumor detection rate. The highest subjective image quality score of the Image 1-S technology is reached by the “Clara + Chroma” mode. Single-use ureteroscopes offer potential advantages over reusable scopes, including sterility, absence of contamination, immediate availability and exemption of previous instrument wear.

Conclusions

Miniaturization, digital image caption and image enhancement technologies seem to be the major determinants defining the best flexible ureteroscope for UTUC treatment. The impact of further factors, such as distal tip design, torque, working channel position, risk of contamination, as well as upcoming technological innovations should be evaluated in randomized controlled trials.
Literatur
1.
Zurück zum Zitat Munoz JJ, Ellison LM (2000) Upper tract urothelial neoplasms: incidence and survival during the last 2 decades. J Urol 164(5):1523–1525CrossRefPubMed Munoz JJ, Ellison LM (2000) Upper tract urothelial neoplasms: incidence and survival during the last 2 decades. J Urol 164(5):1523–1525CrossRefPubMed
3.
Zurück zum Zitat Soria F, Shariat SF, Lerner SP, Fritsche HM, Rink M, Kassouf W, Spiess PE, Lotan Y, Ye D, Fernandez MI, Kikuchi E, Chade DC, Babjuk M, Grollman AP, Thalmann GN (2017) Epidemiology, diagnosis, preoperative evaluation and prognostic assessment of upper-tract urothelial carcinoma (UTUC). World J Urol 35(3):379–387. https://doi.org/10.1007/s00345-016-1928-x CrossRefPubMed Soria F, Shariat SF, Lerner SP, Fritsche HM, Rink M, Kassouf W, Spiess PE, Lotan Y, Ye D, Fernandez MI, Kikuchi E, Chade DC, Babjuk M, Grollman AP, Thalmann GN (2017) Epidemiology, diagnosis, preoperative evaluation and prognostic assessment of upper-tract urothelial carcinoma (UTUC). World J Urol 35(3):379–387. https://​doi.​org/​10.​1007/​s00345-016-1928-x CrossRefPubMed
8.
Zurück zum Zitat Dragos L, Martis SM, Somani B, Bres-Niewada E, Sener TE, Buttice S, Wiseman OJ, Iacoboaie CT, Doizi S, Traxer O (2018) “Torque” Abilities of reusable and single-use flexible ureterorenoscopes: a novel in vitro evaluation of twelve scopes. J Urol 199(4S):e476–e477 Dragos L, Martis SM, Somani B, Bres-Niewada E, Sener TE, Buttice S, Wiseman OJ, Iacoboaie CT, Doizi S, Traxer O (2018) “Torque” Abilities of reusable and single-use flexible ureterorenoscopes: a novel in vitro evaluation of twelve scopes. J Urol 199(4S):e476–e477
17.
Zurück zum Zitat Thomsen HS, Dorph S, Olsen S (1981) Pyelorenal backflow in normal and ischemic rabbit kidneys. Invest Radiol 16(3):206–214CrossRefPubMed Thomsen HS, Dorph S, Olsen S (1981) Pyelorenal backflow in normal and ischemic rabbit kidneys. Invest Radiol 16(3):206–214CrossRefPubMed
27.
Zurück zum Zitat Mandalapu RS, Remzi M, de Reijke TM, Margulis V, Palou J, Kapoor A, Yossepowitch O, Coleman J, Traxer O, Anderson JK, Catto J, de la Rosette J, O’Brien T, Zlotta A, Matin SF (2017) Update of the ICUD-SIU consultation on upper tract urothelial carcinoma 2016: treatment of low-risk upper tract urothelial carcinoma. World J Urol 35(3):355–365. https://doi.org/10.1007/s00345-016-1859-6 CrossRefPubMed Mandalapu RS, Remzi M, de Reijke TM, Margulis V, Palou J, Kapoor A, Yossepowitch O, Coleman J, Traxer O, Anderson JK, Catto J, de la Rosette J, O’Brien T, Zlotta A, Matin SF (2017) Update of the ICUD-SIU consultation on upper tract urothelial carcinoma 2016: treatment of low-risk upper tract urothelial carcinoma. World J Urol 35(3):355–365. https://​doi.​org/​10.​1007/​s00345-016-1859-6 CrossRefPubMed
28.
Zurück zum Zitat Dragos LB, Somani BK, Sener ET, Buttice S, Proietti S, Ploumidis A, Iacoboaie CT, Doizi S, Traxer O (2017) Which flexible ureteroscopes (digital vs. fiber-optic) can easily reach the difficult lower pole calices and have better end-tip deflection: in vitro study on K-box. A PETRA evaluation. J Endourol 31(7):630–637. https://doi.org/10.1089/end.2017.0109 CrossRefPubMed Dragos LB, Somani BK, Sener ET, Buttice S, Proietti S, Ploumidis A, Iacoboaie CT, Doizi S, Traxer O (2017) Which flexible ureteroscopes (digital vs. fiber-optic) can easily reach the difficult lower pole calices and have better end-tip deflection: in vitro study on K-box. A PETRA evaluation. J Endourol 31(7):630–637. https://​doi.​org/​10.​1089/​end.​2017.​0109 CrossRefPubMed
30.
Zurück zum Zitat Faber DJ, Mik EG, Aalders MC, van Leeuwen TG (2003) Light absorption of (oxy-)hemoglobin assessed by spectroscopic optical coherence tomography. Opt Lett 28(16):1436–1438CrossRefPubMed Faber DJ, Mik EG, Aalders MC, van Leeuwen TG (2003) Light absorption of (oxy-)hemoglobin assessed by spectroscopic optical coherence tomography. Opt Lett 28(16):1436–1438CrossRefPubMed
38.
39.
Zurück zum Zitat Gregory E, Simmons D, Weinburg JJ (1988) Care and sterilisation of endourologic instruments. Urol Clin N Am 15(3):541–546 Gregory E, Simmons D, Weinburg JJ (1988) Care and sterilisation of endourologic instruments. Urol Clin N Am 15(3):541–546
44.
Zurück zum Zitat Abraham JB, Abdelshehid CS, Lee HJ, Box GN, Deane LA, Le T, Jellison F, Borin JF, Manipon A, McDougall EM, Clayman RV (2007) Rapid communication: effects of Steris 1 sterilization and Cidex ortho-phthalaldehyde high-level disinfection on durability of new-generation flexible ureteroscopes. J Endourol 21(9):985–992. https://doi.org/10.1089/end.2007.0181 CrossRefPubMed Abraham JB, Abdelshehid CS, Lee HJ, Box GN, Deane LA, Le T, Jellison F, Borin JF, Manipon A, McDougall EM, Clayman RV (2007) Rapid communication: effects of Steris 1 sterilization and Cidex ortho-phthalaldehyde high-level disinfection on durability of new-generation flexible ureteroscopes. J Endourol 21(9):985–992. https://​doi.​org/​10.​1089/​end.​2007.​0181 CrossRefPubMed
Metadaten
Titel
Which flexible ureteroscope is the best for upper tract urothelial carcinoma treatment?
verfasst von
Etienne Xavier Keller
Steeve Doizi
Luca Villa
Olivier Traxer
Publikationsdatum
15.02.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 11/2019
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-019-02675-0

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