Application of 21 F cystoscope sheath combined with 8.0/9.8 F ureteroscope and plasma electroscope in holmium laser lithotripsy on bladder lithiasis

doi:10.3877/cma.j.issn.1674-3253.2024.06.008

Abstract

Abstract:

Objective

To investigate the clinical efficacy of holmium laser lithotripsy of bladder lithiasis between F8.0/9.8 ureteroscopy combined with 21 F cystoscope sheath and plasma electroscope.

Methods

A retrospective study was performed on 112 bladder lithiasis patients admitted from January 2016 to May 2023 in the Urology department of Xinrongqi Hospital. According to different surgical methods，the patients were divided into two groups，including 58 cases in the 21 F cystoscope sheath combined with 8.0/9.8 F ureteroscopy （cystoscope sheath group） and 54 cases in the plasma electroscope（electroscope group）. Operation time，intraoperative flush volume，surgical field satisfaction，length of hospital stay，hospitalization cost，postoperative hematuria duration，urethral pain score，stone clearance rate were compared between the two groups.

Results

There was no significant difference in the preoperative general information between the two groups （P＞0.05）. Compared with plasma electroscope group，cystoscope sheath group showed shorter operation time，higher surgical field satisfaction，less intraoperative flushing，lower hospitalization costs，shorter postoperative hematuria duration and low pain score and higher stone clearance rate （P＜0.05）. There was no significant difference in the length of hospital stay between the two groups （P＞0.05）.

Conclusions

21 F cystoscope sheath combined with 8.0/9.8 F ureteroscopy is safe and effective surgical methods for bladder lithiasis patients using holmium laser lithotripsy. Compared with plasma electroscope，21 F cystoscope sheath combined with 8.0/9.8 F ureteroscopy has the characteristics of higher surgical efficiency，lower hospitalization cost，less surgical trauma，strong operability，better clinical application value and can be popularized widely.

Key words: Cystoscope sheath, Ureteroscopy, Plasma electroscope, Bladder lithiasis, Holmium laser lithotripsy

Chunfeng Wu, Guohan Lu, Ruhe Yao, Jianhui Li, Wenjie Chen, Yu Huang. Application of 21 F cystoscope sheath combined with 8.0/9.8 F ureteroscope and plasma electroscope in holmium laser lithotripsy on bladder lithiasis[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(06): 579-584.

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Figures/Tables 5

组别	例数	年龄［岁，（ $\bar{x}$ ±s）］	体质量指数［kg/m²，（ $\bar{x}$ ±s）］	病程［月，（ $\bar{x}$ ±s）］	ASA分级［例（%）］		膀胱结石表面积［cm²，（ $\bar{x}$ ±s）］	结石CT值［Hu，（ $\bar{x}$ ±s）］
组别	例数	年龄［岁，（ $\bar{x}$ ±s）］	体质量指数［kg/m²，（ $\bar{x}$ ±s）］	病程［月，（ $\bar{x}$ ±s）］	Ⅰ级	Ⅱ级	膀胱结石表面积［cm²，（ $\bar{x}$ ±s）］	结石CT值［Hu，（ $\bar{x}$ ±s）］
膀胱镜鞘组	58	59±14	22±5	12.4±2.3	42（72.41）	16（27.59）	6.9±1.2	908±88
电切镜组	54	63±16	23±5	13.1±3.6	38（70.37）	16（29.63）	6.9±2.2	920±35
统计值		t=1.483	t=1.886	t=0.798	χ²=3.247		t=1.203	t=1.391
P值		0.153	0.072	0.354	0.081		0.198	0.175

组别	例数	年龄［岁，（ $\bar{x}$ ±s）］	体质量指数［kg/m²，（ $\bar{x}$ ±s）］	病程［月，（ $\bar{x}$ ±s）］	ASA分级［例（%）］		膀胱结石表面积［cm²，（ $\bar{x}$ ±s）］	结石CT值［Hu，（ $\bar{x}$ ±s）］
组别	例数	年龄［岁，（ $\bar{x}$ ±s）］	体质量指数［kg/m²，（ $\bar{x}$ ±s）］	病程［月，（ $\bar{x}$ ±s）］	Ⅰ级	Ⅱ级	膀胱结石表面积［cm²，（ $\bar{x}$ ±s）］	结石CT值［Hu，（ $\bar{x}$ ±s）］
膀胱镜鞘组	58	59±14	22±5	12.4±2.3	42（72.41）	16（27.59）	6.9±1.2	908±88
电切镜组	54	63±16	23±5	13.1±3.6	38（70.37）	16（29.63）	6.9±2.2	920±35
统计值		t=1.483	t=1.886	t=0.798	χ²=3.247		t=1.203	t=1.391
P值		0.153	0.072	0.354	0.081		0.198	0.175

组别	例数	手术时间（min）	术中冲水量（ml）	住院时间（d）	住院费用（万元）	术后血尿持续时间（d）
膀胱镜鞘组	58	40±6	2 580±860	4.6±1.0	1.05±0.26	2.56±0.29
电切镜组	54	70±3	3 670±1 112	4.8±1.1	1.45±0.32	5.87±1.32
统计值		t=2.545	t=2.451	t=0.745	t=2.936	t=2.732
P值		0.033	0.016	0.481	0.004	0.007

组别	例数	手术视野满意度		术后尿道疼痛评分		结石清除率
组别	例数	1分	2分	轻度疼痛	中度疼痛	结石清除率
膀胱镜鞘组	58	48（82.76）	10（17.24）	50（86.21）	8（13.79）	57（98.28）
电切镜组	54	39（72.22）	15（27.78）	36（66.67）	18（33.33）	48（88.89）
统计值		χ²=4.378		χ²=5.889		χ²=6.147
P值		0.042		0.023		0.021

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