Initial experiences of disposable digital flexible ureteroscope in the treatment of upper urinary calculi with high risk factors of endoscopic injury

doi:10.3877/cma.j.issn.1674-3253.2022.03.009

Abstract

Abstract:

Objective

To compare the therapeutic effect between disposable digital flexible ureteroscope with reusable ureteroscope in treating of upper urinary calculi with high risk factors of endoscopic injury.

Methods

The clinical data of patients with upper urinary calculi whose RUSS score ≥3 treated by either disposable digital flexible ureteroscope (n=29) or reusable ureteroscope (n=35) in our hospital from June 2019 to September 2020 were analyzed retrospectively. The age, BMI, RUSS score, operation time, postoperative hospital stay, complications and stone-free rate were compared between the two groups.

Results

There was no significant differentce of the mean age, BMI, RUSS score, postoperative hospital stay and Clavien I-II complications rates of the two group between two groups (P>0.05). The operation time and the stone-free rate after 1 month of the disposable digital flexible ureteroscope group and reusable ureteroscope group were (105±10) min and (90±6) min, 75.86%(22/29) and 51.43%(18/35), the differences were statistical significant (P<0.05).

Conclusion

For those patients of upper urinary tract calculi with high risk of endoscopy damage, disposable flexible ureteroscope operation is highly recommended as the response to their recourse to flexible ureteroscope, which can not only improve the surgical effect but also save the economical costs of hospital, hence conduct the reasonable allocation of medical resources.

Key words: Flexible ureteroscope, Disposable, Endoscopic damage, Stone

Jianfeng Lin, zhibin Ye, Fulv Liang, Xianming Fan, Liren Hu, Jianping Tu, Zhaojian Guo. Initial experiences of disposable digital flexible ureteroscope in the treatment of upper urinary calculi with high risk factors of endoscopic injury[J]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(03): 231-234.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjmnmwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3253.2022.03.009

https://zhqjmnmwkzz.cma-cmc.com.cn/EN/Y2022/V16/I03/231

Figures/Tables 1

References 17

[1]	Alenezi H, Denstedt JD. Flexible ureteroscopy: technological advancements, current indications and outcomes in the treatment of urolithiasis[J]. Asian J Urol, 2015, 2(3): 133-141.
[2]	梁福律，涂建平，林剑峰, 等. 超微经皮肾镜与电子输尿管软镜治疗肾中,上盏2.0~2.5 cm结石疗效的比较[J]. 临床泌尿外科杂志, 2019, 34(12): 965-968.
[3]	Al-Badr W, Martin KJ. Vitamin D and kidney disease [J]. Clin J Am Soc Nephrol, 2008, 3(5): 1555-1560.
[4]	Davis NF, Quinlan MR, Browne C, et al. Single-use flexible ureteropyeloscopy: a systematic revie[J]. World J Urol, 2018, 36(4): 529-536.
[5]	朱玮，莫承强，陈玢磆. 一次性输尿管软镜与可重复使用输尿管软镜治疗上尿路结石疗效的前瞻性多中心随机对照研究[J]. 中华泌尿外科杂志2020, 41(4): 287-291.
[6]	Hennessey DB, Fojecki GL, Papa NP, et al. Single-use disposable digital flexible ureteroscopes: an ex vivo assessment and costanalysis [J]. BJU Int, 2018, 121(Suppl 3): S55-S61.
[7]	Resorlu B, Unsal A, Gulec H, et al. A new scoring system for predicting stone-free rate after retrograde intrarenal surgery: The "resorlu-Unsal Stone Score" [J]. Urology, 2012, 80(3): 512-517.
[8]	Semins MJ, George S, Allaf ME, et al. Ureteroscope cleaning and sterilization by the urology operating room team: the effect on repaircosts [J]. J Endourol, 2009, 23(6): 903-905.
[9]	De la Rosette JJ, Zuazu JR, Tsakiris P, et al. Prognostic factors and percutaneous nephrolithotomy morbidity: a multivariate analysis of a contemporary series using the Clavien classification [J]. J Urol, 2008, 180(6): 2489-2493.
[10]	Qi S, Yang E, Bao J, et al. Single-use versus reusable digital flexible ureteroscopes for the treatment of renal calculi: a prospective multicenter randomized controlled trial [J]. J Endourol, 2020, 34(1): 18-24.
[11]	Winship B, Wollin D, Carlos E, et al. Avoiding a lemon: performance consistency of single-use ureteroscopes [J]. J Endourol, 2019, 33: 127-131.
[12]	徐巍，黄晨，赖德辉, 等．电子输尿管软镜联合U100Plus激光治疗上尿路2~3 cm结石的疗效研究[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2020, 14(3): 200-203.
[13]	肖博，靳松，姬超岳. 国产一次性电子输尿管软镜在上尿路结石治疗中的初步应用经验[J]. 中华泌尿外科杂志, 2020, 41(8): 609-612.
[14]	Martin CJ, Mcadams SB, Abdul-Muhsin H, et al. The economicimplications of a reusable flexible digital ureteroscope: A cost-benefit analysis [J]. J Urol, 2017, 197(3 Pt 1): 730-735.
[15]	Marchini GS, Batagello CA, Monga M, et al. In vitro evaluation of single-use digital flexible ureteroscopes: A practical comparison for apatient-centered approach [J]. J Endourol, 2018, 32(3) : 184-191.
[16]	Dale J, Kaplan AG, R advak D, et al. Evaluation of a novel single-use flexible ureteroscope [J]. J Endourol, 2021, 35(6): 903-907.
[17]	杨恩广, 一次性输尿管软镜的应用现状及研究进展[J]. 中国微创外科杂志期刊, 2019, 9(19): 846-848.

组别	例数	年龄[岁，(±s)]	性别(例)		BM[kg/m²，(±s)]	手术时间[min，(±s)]	术后住院[d，(±s)]	并发症ClavienⅠ~Ⅱ(例)	术后1个月清石率[例(%)]
组别	例数	年龄[岁，(±s)]	男	女	BM[kg/m²，(±s)]	手术时间[min，(±s)]	术后住院[d，(±s)]	并发症ClavienⅠ~Ⅱ(例)	术后1个月清石率[例(%)]
一次性软镜组	29	47±12	19	10	24.99±2.90	105±10	3.21±0.62	5	22(75.86)
可重复软镜组	35	47±14	19	08	24.13±2.98	90±6	3.26±0.43	7.	18(51.43)
统计值		t=-0.034	χ² =0.829		t=1.154	t=6.918	t=-0.383	χ² =0.079	χ² =4.040
P值		0.973	0.362		0.253	<0.001	0.703	0.778	0.044
组别	结石直径>20 mm积分	肾下盏结石且夹角<45°(例)	结石多发(含鹿角形结石)(例)	肾盏解剖结构异常(例)	RUSS评分(例)			RUSS总评分
组别	结石直径>20 mm积分	肾下盏结石且夹角<45°(例)	结石多发(含鹿角形结石)(例)	肾盏解剖结构异常(例)	3分	4分	5分	RUSS总评分
一次性软镜组	2.03±0.50	24	20	2	10	14	5	3.83±0.71
可重复软镜组	2.00±0.30	23	24	4	10	23	2	3.07±0.55
统计值	t=0.327	χ²=2.362	χ²=0.001	χ²=0.383	χ²=0.258	χ²=1.977	χ²=2.163	t=0.357
P值	0.745	0.124	0.973	0.536	0.612	0.160	0.141	0.722

组别	例数	年龄[岁，(±s)]	性别(例)		BM[kg/m²，(±s)]	手术时间[min，(±s)]	术后住院[d，(±s)]	并发症ClavienⅠ~Ⅱ(例)	术后1个月清石率[例(%)]
组别	例数	年龄[岁，(±s)]	男	女	BM[kg/m²，(±s)]	手术时间[min，(±s)]	术后住院[d，(±s)]	并发症ClavienⅠ~Ⅱ(例)	术后1个月清石率[例(%)]
一次性软镜组	29	47±12	19	10	24.99±2.90	105±10	3.21±0.62	5	22(75.86)
可重复软镜组	35	47±14	19	08	24.13±2.98	90±6	3.26±0.43	7.	18(51.43)
统计值		t=-0.034	χ² =0.829		t=1.154	t=6.918	t=-0.383	χ² =0.079	χ² =4.040
P值		0.973	0.362		0.253	<0.001	0.703	0.778	0.044
组别	结石直径>20 mm积分	肾下盏结石且夹角<45°(例)	结石多发(含鹿角形结石)(例)	肾盏解剖结构异常(例)	RUSS评分(例)			RUSS总评分
组别	结石直径>20 mm积分	肾下盏结石且夹角<45°(例)	结石多发(含鹿角形结石)(例)	肾盏解剖结构异常(例)	3分	4分	5分	RUSS总评分
一次性软镜组	2.03±0.50	24	20	2	10	14	5	3.83±0.71
可重复软镜组	2.00±0.30	23	24	4	10	23	2	3.07±0.55
统计值	t=0.327	χ²=2.362	χ²=0.001	χ²=0.383	χ²=0.258	χ²=1.977	χ²=2.163	t=0.357
P值	0.745	0.124	0.973	0.536	0.612	0.160	0.141	0.722

Please choose a citation manager

Content to export