Efficacy analysis of tip-flexible suction access sheath during flexible ureteroscopic lithotripsy for unilateral upper urinary tract calculi.

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY World Journal of Urology Pub Date : 2024-11-05 DOI:10.1007/s00345-024-05325-2
Zhaoxin Ying, Hao Dong, Chao Li, Shuwei Zhang, Yin Chen, Minjie Chen, Yonghan Peng, Xiaofeng Gao
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Abstract

Purpose: This study aims to evaluate the efficacy of tip-flexible suctioning ureteral access sheath (TFS-UAS) compared to traditional ureteral access sheath (T-UAS) in flexible ureteroscopic lithotripsy (FURL) for unilateral upper urinary tract calculi.

Methods: The study retrospectively compared outcomes from 103 cases using TFS-UAS and 138 using T-UAS treated with FURL for unilateral upper urinary tract calculi from January to October 2023. Assessed parameters included patient demographics, stone characteristics, preoperative urine cultures, ureteral pre-stenting, comorbidities, procedure time, stone-free rate (SFR), utilization of stone retrieval baskets, and postoperative Systemic Inflammatory Response Syndrome (SIRS) rates. The maximum angle of deflection was also measured when the flexible ureteroscope was located in different parts of the TFS-UAS with different diameters in vitro.

Results: The TFS-UAS group achieved a higher Immediate SFR (76.70% vs. 63.77%, p = 0.031) and final SFR (89.32% vs. 73.91%, p = 0.003) than the T-UAS group, especially in the lower calyx stones (80.00% vs. 41.18%, p = 0.018) and upper urinary tract calculi with a cumulative diameter of 2 cm or larger (68.97% vs. 42.11%, p = 0.029). Notably, TFS-UAS with a 10 French (F) inside diameter size achieved a higher SFR (88.57% vs. 70.59%, p = 0.041) and a greater deflection angle than the 12.5 F inside diameter size. No significant variations were observed in the operative duration, hospitalization duration and the occurrence of SIRS between the compared cohorts.

Conclusion: TFS-UAS significantly improves SFR in FURL treatment of unilateral upper urinary tract calculi, particularly for stones located in the lower calyx or with a cumulative diameter of 2 cm or greater, compared to T-UAS.

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在柔性输尿管镜碎石术治疗单侧上尿路结石时使用尖端柔性抽吸通道鞘的疗效分析。
目的:本研究旨在评估尖端柔性抽吸输尿管通路鞘管(TFS-UAS)与传统输尿管通路鞘管(T-UAS)在柔性输尿管镜碎石术(FURL)治疗单侧上尿路结石中的疗效:该研究回顾性比较了2023年1月至10月使用TFS-UAS治疗单侧上尿路结石的103例病例和使用T-UAS治疗单侧上尿路结石的138例病例的疗效。评估参数包括患者人口统计学特征、结石特征、术前尿液培养、输尿管预置支架、合并症、手术时间、无结石率(SFR)、取石篮使用率和术后全身炎症反应综合征(SIRS)发生率。此外,还测量了柔性输尿管镜位于体外不同直径的 TFS-UAS 不同部位时的最大偏转角度:结果:TFS-UAS 组的即时 SFR(76.70% vs. 63.77%,p = 0.031)和最终 SFR(89.32% vs. 73.91%,p = 0.003)均高于 T-UAS 组,尤其是在下萼结石(80.00% vs. 41.18%,p = 0.018)和累计直径大于等于 2 厘米的上尿路结石(68.97% vs. 42.11%,p = 0.029)方面。值得注意的是,内径为 10 英尺(F)的 TFS-UAS 比内径为 12.5 英尺(F)的 TFS-UAS 获得了更高的 SFR(88.57% vs. 70.59%,p = 0.041)和更大的偏转角。在手术时间、住院时间和 SIRS 发生率方面,比较组间未观察到明显差异:结论:与 T-UAS 相比,TFS-UAS 能明显改善 FURL 治疗单侧上尿路结石的 SFR,尤其是位于下肾萼或累计直径大于或等于 2 厘米的结石。
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来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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