Clinical effect analysis of ureteral access sheath assisted ureteroscopy in the treatment of ureteral calculi

doi:10.3877/cma.j.issn.1674-3253.2021.02.006

Abstract

Abstract:

Objective

To compare the operative efficiency, postoperative efficacy and complications of ureteroscopic lithotripsy with or without ureteral access sheath (UAS).

Methods

Pre-operative and post-operative data of 92 patients who underwent ureteroscopic lithotripsy for ureteral calculi in The Third Affiliated Hospital of Sun Yat-sen University from October 2017 to October 2019 were analyzed retrospectively. Patients were divided into UAS group and no UAS (NUAS) group. The basic information, stone burden, operation time, hospitalization time, fever and stone-free rate were compared.

Results

UAS was used in 42.4% (39/92) patients. The UAS group had greater stone burden compared to the NUAS group [(107±67) mm² vs (66±42)mm², P=0.001].There were no differences in the amount of stone burden treated per minute in the UAS group and the NUAS group. There was 1 case (2.3%) of postoperative residual calculi in the UAS group and 6 cases (11.3%) of NUAS group with residual calculi. Intraoperative and postoperative complications in two groups had no statistical difference. In terms of calculi in the middle and upper ureteral segments, 27 patients (45.8%) were treated with UAS. The amount of stone burden treated per minute was higher in the UAS group than NUAS group [(2.4±1.3) mm²/min vs (1.7±1.0) mm²/min, P=0.029].

Conclusion

In the treatment of middle and upper ureteral calculi, the use of ureteral access sheath can improve the surgical efficiency, but does not increase the risk of intraoperative and postoperative complications.

Key words: Ureterolithiasis, Ureteroscope, Ureteral access sheath

Xiaokang Li, Yunhua Mao, Dongming Xiao, Jie Situ. Clinical effect analysis of ureteral access sheath assisted ureteroscopy in the treatment of ureteral calculi[J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(02): 113-116.

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References 15

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组别	例数	性别		年龄[岁，(±s)]	患侧（例）		结石位置（例）			结石负荷[mm²/min，(±s)]
组别	例数	男	女	年龄[岁，(±s)]	左	右	上	中	下	结石负荷[mm²/min，(±s)]
有鞘组	39	18	21	54±16	18	21	17	10	12	107±67
无鞘组	53	33	20	51±13	33	20	23	9	21	66±42
统计值		χ²=3.637		t=0.761	χ²=2.360		χ²=1.307			t=3.604
P值		0.056		0.449	0.124		0.520			0.001

组别	例数	性别		年龄[岁，(±s)]	患侧（例）		结石位置（例）			结石负荷[mm²/min，(±s)]
组别	例数	男	女	年龄[岁，(±s)]	左	右	上	中	下	结石负荷[mm²/min，(±s)]
有鞘组	39	18	21	54±16	18	21	17	10	12	107±67
无鞘组	53	33	20	51±13	33	20	23	9	21	66±42
统计值		χ²=3.637		t=0.761	χ²=2.360		χ²=1.307			t=3.604
P值		0.056		0.449	0.124		0.520			0.001

组别	例数	整体手术效率[mm²/min，(±s)]	中上段结石手术效率[mm²/min，(±s)]	结石残留[例，(%)]	术后住院时间[d，(±s)]	术后白细胞升高[例，(%)]	术后发热[例，(%)]
有鞘组	39	2.2±1.3	2.4±1.3	1（2.6）	1.7±1.5	7（17.9）	2（5.1）
无鞘组	53	1.9±1.2	1.7±1.0	6（11.3）	1.5±1.2	11（20.8）	0
统计值		t=1.229	t=2.247	χ²=2.256	t=0.826	χ²=0.112	χ²=2.778
P值		0.222	0.029	0.133	0.411	0.737	0.096

组别	例数	整体手术效率[mm²/min，(±s)]	中上段结石手术效率[mm²/min，(±s)]	结石残留[例，(%)]	术后住院时间[d，(±s)]	术后白细胞升高[例，(%)]	术后发热[例，(%)]
有鞘组	39	2.2±1.3	2.4±1.3	1（2.6）	1.7±1.5	7（17.9）	2（5.1）
无鞘组	53	1.9±1.2	1.7±1.0	6（11.3）	1.5±1.2	11（20.8）	0
统计值		t=1.229	t=2.247	χ²=2.256	t=0.826	χ²=0.112	χ²=2.778
P值		0.222	0.029	0.133	0.411	0.737	0.096

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