Ureteral Access Sheaths Safe in Urothelial Carcinoma

Ureteral access sheaths safe for diagnosis and treatment of upper tract urothelial carcinoma

MONDAY, Sept. 12 (HealthDay News) -- Ureteral access sheaths (UASs) are safe for use in the diagnosis and treatment of upper tract urothelial carcinoma (UTUC), facilitate acquisition of multiple biopsy specimens adequate for histopathologic evaluation, and minimize the need for repeat diagnostic procedures, according to a study published in the September issue of Urology.

Michael A. Gorin, M.D., from the University of Miami Miller School of Medicine, and colleagues described their experience with UASs in the diagnosis and treatment of UTUC in 125 patients who underwent 235 ureteroscopy procedures for suspicion of UTUC. Of these, 64 patients with significant urothelial lesions in the proximal upper urinary tract underwent 85 sheath-inclusive procedures. Data were collected for demographic information, comorbidity, operative complications, and pathology results. The nephroureterectomy specimens, and histologic grade of ureteroscopic biopsies were evaluated for concordance.

The investigators found that sheath deployment was successful in 97.6 percent of the patients. Biopsy specimens were adequate for histopathologic diagnosis in 90.4 percent of cases. No UAS-related complications were noted. A total of 34 out of 125 patients underwent removal of 35 renal units. The tumor grade concordance between biopsy and nephroureterectomy specimens was 88.6 percent.

"Our experience has demonstrated that UASs are safe for use in the diagnosis and treatment of UTUC. The placement of a UAS facilitates procurement of biopsy specimens adequate for histopathologic evaluation, results in a high diagnostic yield, and minimizes the need for repeat diagnostic procedures," the authors write.

Two of the sheaths used in the study were manufactured by Applied Medical; one study author disclosed being a lecturer for Applied Medical.

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