Efficacy of flexible negative pressure ureteral access sheath plus disposable flexible ureteroscope versus SMP in the treatment of 2-3 cm renal calculi
10.3969/j.issn.1009-8291.2024.07.011
- VernacularTitle:可弯曲负压鞘联合一次性输尿管软镜与超微经皮肾镜治疗2～3cm肾结石的疗效比较
- Author:
Jianfeng LIN
1
;
Zhibin YE
;
Liren HU
;
Fulyu LIANG
;
Jianping TU
;
Chaohao MIAO
;
Xianming FAN
Author Information
1. 福建中医药大学附属厦门市第三医院泌尿外科,福建厦门 361100
- Keywords:
renal calculi;
flexible negative pressure ureteral access sheath;
flexible ureteroscope;
super-mini-percutaneous nephrolithotomy
- From:
Journal of Modern Urology
2024;29(7):617-621,626
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy of negative pressure ureteral access sheath combined with disposable flexible ureteroscope(UAS+FRUS)in the treatment of renal calculi of 2-3 cm,so as to provide reference for the treatment.Methods A retrospective analysis was conducted on 130 cases of renal calculi of 2-3 cm treated with surgery in Xiamen Third Hospital during Sep.2021 and Sep.2023,including 68 cases with UAS+FRUS and 62 cases with super-mini percutaneous nephrolithotripsy(SMP).The perioperative indexes and stone-clearance rate(SFR)were compared between the two groups.Results All operations were successful.There were no statistically significant differences in the total SFR and incidence of complications(5.88％vs.9.67％)between the two groups 3 days(88.24％vs.90.32％)and 1 month(91.18％vs.93.55％)after surgery(P＞0.05).For patients with lower calyceal calculi with infundibulopelvic angle(IPA)＜45°,the SFR of the UAS+FRUS group was significantly lower than that of the SMP group(57.14％vs.100％,P＜0.05).The UAS+FRUS group had a longer operation time than the SMP group[(104.94±8.79)minutes vs.(77.98±6.60)minutes,P＜0.001],higher hospitalization costs[(23 112.82±1152.34)yuan vs.(21 975.84±1512.24)yuan,P＜0.001],less postoperative decrease in hemoglobin[(6.71±2.07)g/L vs.(9.81±4.80)g/L,P＜0.001],and shorter postoperative hospitalization time[(3.28±0.51)d vs.(5.58±0.71)d,P＜0.001].The UAS+FRUS group had lower postoperative VAS score at 6,24,and 48 hours than the SMP group[(6.38±0.69)vs.(7.87±0.88);(3.62±0.73)vs.(5.81±0.83)and(3.12±0.33)vs.(3.81±0.60)],with statistical significance(P＜0.05).Conclusion Both surgical methods have a high SFR in the treatment of renal calculi of 2-3 cm.SMP has the advantages of short operation time,low hospitalization costs,and high SFR for lower calyx calculi,while UAS+FURS has the advantages of little bleeding,minimal trauma,and short hospital stay.Surgeons can make reasonable choices based on the patients'condition and willingness,combined with their own surgical experience.
