Comparative efficacy and safety of intelligent pressure-controlled versus flexible vacuum-assisted ureteral access sheath for 2-4 cm renal calculi.

IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Minerva Urology and Nephrology Pub Date : 2024-08-02 DOI:10.23736/S2724-6051.24.05814-2
Xin Huang, Leming Song, Xiaolin Deng, Hua Chen, Jiansheng Xiao, Jin Kuang, Zhiwen Wang, Xiaoling Deng, Qiliang Zhai
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Abstract

Background: Retrograde intrarenal surgery (RIRS) is being increasingly used to treat 2-4 cm renal stones, which can be attributed to advances in flexible ureteroscopes and ureteral access sheaths (UASs). Despite the improvement and application of flexible vacuum-assisted (FV) and intelligent pressure-controlled (IPC) UASs, no studies have compared their therapeutic efficacy and safety. Therefore, this study aimed to compare the therapeutic efficacy and safety of IPC-UAS and FV-UAS in RIRS 2-4 cm renal stones.

Methods: We included 96 and 103 patients who underwent IPC-UAS and FV-UAS RIRS, respectively, for 2-4 cm renal stones. Stone-free rate (SFR), operative time, and complications were compared between the two groups.

Results: The immediate SFR was 69.8% and 82.5% in the IPC-UAS and FV-UAS groups, respectively (P<0.05). There were no significant between-group differences in the 1-month SFR (84.4% vs. 84.5%, P>0.05). The IPC-UAS group had a shorter hospital stay (5.2±2.4 vs. 6.2±3.2 days, P=0.018) and lower cost (CNY13014.7±3240.7 vs. CNY14022.5±2301.6, P=0.012) than the FV-UAS group. There were no significant between-group differences in operative time or complications.

Conclusions: Regarding RIRS for 2-4 cm renal stones, the IPC-UAS group can achieve a 1-month SFR similar to that of the FV-UAS group, with shorter hospitalization and lower cost. Additionally, the IPC-UAS is a promising device for efficient and safe RIRS, considering its intelligent pressure regulation. Our findings could inform optimal UAS selection for managing large renal calculi and demonstrate the utility of the novel IPC-UAS in improving outcomes of RIRS for 2-4 cm renal stones.

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智能压力控制与柔性真空辅助输尿管接入鞘治疗 2-4 厘米肾结石的疗效和安全性比较。
背景:逆行肾内手术(RIRS)越来越多地用于治疗2-4厘米的肾结石,这归功于柔性输尿管镜和输尿管通道鞘(UAS)的进步。尽管柔性真空辅助(FV)和智能压力控制(IPC)UAS得到了改进和应用,但还没有研究对其治疗效果和安全性进行比较。因此,本研究旨在比较 IPC-UAS 和 FV-UAS 对 RIRS 2-4 厘米肾结石的疗效和安全性:我们分别纳入了 96 名和 103 名接受 IPC-UAS 和 FV-UAS RIRS 的 2-4 厘米肾结石患者。比较了两组患者的无结石率(SFR)、手术时间和并发症:结果:IPC-UAS组和FV-UAS组的即时无石率分别为69.8%和82.5%(P0.05)。IPC-UAS组比FV-UAS组住院时间短(5.2±2.4天 vs. 6.2±3.2天,P=0.018),费用低(13014.7±3240.7元人民币 vs. 14022.5±2301.6元人民币,P=0.012)。手术时间和并发症在组间无明显差异:结论:就2-4厘米肾结石的RIRS而言,IPC-UAS组的1个月SFR与FV-UAS组相似,住院时间更短,费用更低。此外,考虑到其智能压力调节功能,IPC-UAS 是一种有望实现高效、安全 RIRS 的设备。我们的研究结果可以为管理大型肾结石的 UAS 选择提供参考,并证明了新型 IPC-UAS 在改善 2-4 厘米肾结石 RIRS 治疗效果方面的实用性。
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来源期刊
Minerva Urology and Nephrology
Minerva Urology and Nephrology UROLOGY & NEPHROLOGY-
CiteScore
8.50
自引率
32.70%
发文量
237
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