Lasselin J, Viart L, Lasselin-Boyard P, Raynal G, Saint F
Service d'urologie transplantation, CHU d'Amiens, avenue Laennec, 80480 Salouel, France.
Service d'urologie transplantation, CHU d'Amiens, avenue Laennec, 80480 Salouel, France.
Prog Urol. 2015 Apr;25(5):265-73. doi: 10.1016/j.purol.2015.01.010. Epub 2015 Feb 14.
To evaluate predictors of flexible ureterorenoscopes breakage and damage of their optical beam.
Retrospective survey, single center on 393 interventions with 4 flexible ureterorenoscopes between January 2009 and March 2013. We analyzed factors linked to patient, pathology and surgical technique.
We identified 21 major accidents, a breakage rate of 5.34% and 76 pixels losses in the maintenance of endoscopes and 10 during the procedure. The only statistically significant predictor of loss was the cumulative duration of operating time since the last repair (P=0.04, OR=1.001 [1-1001]). For lesions of the optical beam between the procedures, parameters appearing as significant were the ureterorenoscope model (P=0.01, OR=2.558, 95% CI [1229-5326]), the use of instruments by the working channel: the laser (P=0.02, OR=2.06, 95% CI [1109-3827]), or the use of endoluminal graspers (P=0.007, OR=0.467, 95% CI [0269-0809]). Intraoperatively, the number of open or laparoscopic surgery (P=0.007, OR=3.105, 95% CI [1364-7068]), duration of intervention (P=0.01, OR=1.023, 95% CI [1.006-1041]) and the cumulative duration of intervention (P=0.003, OR=1.001, 95% CI [1-1002]) appeared to be statistically significant.
The only predictor of loss of equipment under repair was the cumulative duration of operation time. It has not been demonstrated any difference between ureterorenoscopes. It was during the endoscopes disinfection that the majority of optical beam lesions take place.
评估可弯曲输尿管肾镜破损及其光束损坏的预测因素。
回顾性调查,单中心研究,纳入2009年1月至2013年3月期间使用4台可弯曲输尿管肾镜进行的393例手术。分析与患者、病理及手术技术相关的因素。
我们确定了21起重大事故,破损率为5.34%,内镜维护期间有76个像素损失,手术过程中有10个像素损失。唯一具有统计学意义的损失预测因素是自上次维修以来的累计手术时间(P = 0.04,OR = 1.001 [1 - 1.001])。对于手术之间的光束损伤,具有统计学意义的参数包括输尿管肾镜型号(P = 0.01,OR = 2.558,95% CI [1.229 - 5.326])、工作通道使用器械情况:激光(P = 0.02,OR = 2.06,95% CI [1.109 - 3.827]),或使用腔内抓钳(P = 0.007,OR = 0.467,95% CI [0.269 - 0.809])。术中,开放或腹腔镜手术次数(P =