Berquet Gaetan, Prunel Paul, Verhoest Grégory, Mathieu Romain, Bensalah Karim
Department of Urology, Pontchaillou University Hospital, University of Rennes 1, 35000, 2 Rue Henri le Guilloux, Rennes, France,
World J Urol. 2014 Feb;32(1):229-32. doi: 10.1007/s00345-013-1181-5. Epub 2013 Oct 29.
To evaluate the impact of a ureteral access sheath (UAS) on stone-free (SF) rate after flexible ureteroscopy for upper urinary tract stones.
We retrospectively reviewed 280 patients who underwent flexible ureteroscopy (URS) for upper urinary tract stone between 2009 and 2012. Patients were divided into two groups based on whether a UAS was used (n = 157) or not (n = 123). SF rate was evaluated at one and three months after surgery by abdominal imaging. Quantitative and qualitative variables were compared with Student's t test and χ2 test, respectively. A logistic regression model was used to determine the predictive factors of SF status.
Stone size was similar in both groups (15.1 vs. 13.7 mm, p = 0.21). SF rates at one and 3 months were comparable in UAS and non-UAS groups (76 vs. 78% and 86 vs. 87%, p = 0.88 and 0.89, respectively). Complication rates were similar in both groups (12.7 vs. 12.1%, p = 0.78). In multivariable analysis, stone size was the only predictive factor of SF rate (p = 0.016).
The routine use of a UAS did not improve SF rate in patients undergoing flexible URS for upper urinary tract calculi.
评估输尿管通路鞘（UAS）对上尿路结石软性输尿管镜检查术后无结石率（SF）的影响。
我们回顾性分析了2009年至2012年间280例行上尿路结石软性输尿管镜检查（URS）的患者。根据是否使用UAS将患者分为两组（使用组n = 157，未使用组n = 123）。术后1个月和3个月通过腹部影像学评估无结石率。定量和定性变量分别采用Student t检验和χ2检验进行比较。采用逻辑回归模型确定无结石状态的预测因素。
两组结石大小相似（15.1 vs. 13.7 mm, p = 0.21）。UAS组和非UAS组术后1个月和3个月的无结石率相当（分别为76% vs. 78%和86% vs. 87%，p = 0.88和0.89）。两组并发症发生率相似（12.7% vs. 12.1%，p = 0.78）。多变量分析中，结石大小是无结石率的唯一预测因素（p = 0.016）。
对于接受上尿路结石软性URS的患者，常规使用UAS并不能提高无结石率。
