Division of Endourology and Stone Disease, Department of Urology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA.
Nat Rev Urol. 2015 May;12(5):281-8. doi: 10.1038/nrurol.2015.74. Epub 2015 Apr 14.
Flexible ureteroscopy (URS) is increasingly being used as the first-line treatment for patients with renal stones. Despite this increase in use, substantial variations exist in the reported stone-free rates (SFR) following flexible URS. These variations are a result of inconsistencies in the definition of 'stone-free', which reflect variations in the type of imaging used to assess the presence of stones postoperatively and the timing of the assessment. Other possible factors such as the importance of residual fragments following stone surgery, and the size and position of the stones might also account for variations in stone-free rates. In order to obtain an accurate estimate of the SFR, especially within subgroups defined by stone characteristics and exact technique, we compare reported SFRs from studies that use imaging other than CT for follow-up and those that use only CT. We also review the evidence on the importance of active retrieval of fragments during flexible URS and whether this technique improves the outcomes of patients with kidney stones.
软性输尿管镜检查（URS）越来越多地被用作肾结石患者的一线治疗方法。尽管使用量有所增加，但软性 URS 后报告的无石率（SFR）存在很大差异。这些差异是由于“无石”定义的不一致造成的，这反映了术后评估结石存在时使用的影像学类型和评估时间的差异。其他可能的因素，如结石手术后残余碎片的重要性，以及结石的大小和位置，也可能导致无石率的差异。为了准确估计 SFR，特别是在根据结石特征和确切技术定义的亚组中，我们比较了使用 CT 以外的影像学方法进行随访的研究报告的 SFR 和仅使用 CT 的研究报告的 SFR。我们还回顾了软性 URS 期间主动取石碎片的重要性的证据，以及该技术是否改善肾结石患者的治疗效果。
