Application of intelligent pressure-controlled flexible ureteroscopic suctioning lithotripsy in upper urinary tract stones with diameter of 10-25 mm

doi:10.3877/cma.j.issn.1674-3253.2024.05.013

Abstract

Abstract:

Objective

To compare the safety and efficacy of intelligent pressure-controlled flexible ureteroscopic suctioning lithotripsy (IPFUSL) with retrograde intrarenal surgery (RIRS) in the treatment of upper urinary tract stones with diameter of 10 to 25 mm.

Methods

The clinical data of 85 patients with upper urinary tract stones who underwent surgical treatment and completed post-operative follow-up at the Department of Urology, Guangdong Medical University Hospital from June 2021 to August 2022 were recorded. Patients were grouped according to whether they received IPFUSL, 43 patients received IPFUSL as the observation group and 42 patients received conventional RIRS as the control group. Comparison of laboratory indicators before and after surgery, time of surgery, stone removal rate at 1 month after surgery, post-operative hospital stay and complication rate.

Results

All 85 patients successfully completed the operation. There was no statistical significance in preoperative baseline data, postoperative leukocyte rise, hemoglobin decline, creatinine change values and postoperative procalcitonin levels between the two groups (P>0.05). There was no significant difference in stone free rate 1 month after operation between two groups (83.7% vs 73.8%, P>0.05). The postoperative hospitalization stay in the observation group was shorter than the control group [(1.2±0.4) d vs (1.5±0.8) d, P=0.045]. The incidence of surgical complications in the observation group was significantly lower than the control group [4.7% vs 21.4%, P=0.021].

Conclusions

IPFUSL and RIRS are both safe and effective surgical methods for the treatment of upper urinary stones with diameters of 10 to 25 mm. The stone free rate of them is similar, but the former has better safety, and has the advantages of quick postoperative recovery and short hospital stay, which is worthy of promotion in clinical practice.

Key words: Upper urinary tract stones, Flexible ureteroscopy, Intelligent pressure control, Artificial intelligence (AI), Efficacy, Retrograde intrarenal surgery

Qizhou Mo, Jin Su, Jian Huang, Jianwei Li, Sining Li, Jianjun Liu. Application of intelligent pressure-controlled flexible ureteroscopic suctioning lithotripsy in upper urinary tract stones with diameter of 10-25 mm[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(05): 497-502.

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References 25

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组别	例数	性别(例)		年龄[岁，(±s)]	结石直径[mm，(±s)]	BMI[kg/m²，(±s)]	结石CT值[Hu，M(Q)]	肾积水程度(例)		结石位置(例)
组别	例数	男	女	年龄[岁，(±s)]	结石直径[mm，(±s)]	BMI[kg/m²，(±s)]	结石CT值[Hu，M(Q)]	无或轻度	中度	肾盏	肾盂	输尿管上段	复合结石
观察组	43	30	13	49±10	18±5	24±3	1 087(811，1 302)	25	18	6	11	21	5
对照组	42	30	12	47±13	17±4	24±4	1 144(472，1 433)	30	12	7	9	19	7
统计值		χ²=0.028		t=0.902	t=0.845	t=0.363	Z=-0.075	χ²=1.643		χ²=3.636
P值		0.867		0.370	0.400	0.718	0.940	0.200		0.726

组别	例数	性别(例)		年龄[岁，(±s)]	结石直径[mm，(±s)]	BMI[kg/m²，(±s)]	结石CT值[Hu，M(Q)]	肾积水程度(例)		结石位置(例)
组别	例数	男	女	年龄[岁，(±s)]	结石直径[mm，(±s)]	BMI[kg/m²，(±s)]	结石CT值[Hu，M(Q)]	无或轻度	中度	肾盏	肾盂	输尿管上段	复合结石
观察组	43	30	13	49±10	18±5	24±3	1 087(811，1 302)	25	18	6	11	21	5
对照组	42	30	12	47±13	17±4	24±4	1 144(472，1 433)	30	12	7	9	19	7
统计值		χ²=0.028		t=0.902	t=0.845	t=0.363	Z=-0.075	χ²=1.643		χ²=3.636
P值		0.867		0.370	0.400	0.718	0.940	0.200		0.726

	例数	手术时间[min，(±s)]	术后血白细胞上升值[×10⁹/L，(±s)]	术后血红蛋白下降量[g/L，(±s)]	术后血肌酐变化值[μmol/L，M(Q)]	术后PCT值[ng/mL，M(Q)]	术后住院时间[d，(±s)]	术后1月结石清除率(%)
观察组	43	59±19	4.0±3.0	7±6	-1.0(-10.0，6.0)	0.06(0.03，0.11)	1.2±0.4	83.7
对照组	42	54±25	3.6±2.7	8±6	-1.0(-7.3，10.0)	0.06(0.03，0.09)	1.5±0.8	73.8
统计值		t=1.095	t=0.650	t=-1.229	Z=-0.809	Z=-0.145	t=-2.034	χ²=1.250
P值		0.276	0.518	0.223	0.418	0.884	0.045	0.263

	例数	手术时间[min，(±s)]	术后血白细胞上升值[×10⁹/L，(±s)]	术后血红蛋白下降量[g/L，(±s)]	术后血肌酐变化值[μmol/L，M(Q)]	术后PCT值[ng/mL，M(Q)]	术后住院时间[d，(±s)]	术后1月结石清除率(%)
观察组	43	59±19	4.0±3.0	7±6	-1.0(-10.0，6.0)	0.06(0.03，0.11)	1.2±0.4	83.7
对照组	42	54±25	3.6±2.7	8±6	-1.0(-7.3，10.0)	0.06(0.03，0.09)	1.5±0.8	73.8
统计值		t=1.095	t=0.650	t=-1.229	Z=-0.809	Z=-0.145	t=-2.034	χ²=1.250
P值		0.276	0.518	0.223	0.418	0.884	0.045	0.263

组别	例数	输尿管损伤	发热(T>38℃)	血尿	肾绞痛	输血	脓毒血症	总并发症
观察组	43	0	1(2.3)	1(2.3)	0	0	0	2(4.7)
对照组	42	1(2.4)	4(9.5)	2(4.8)	2(4.8)	0	0	9(21.4)
χ²值								5.308
P值								0.021

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