Doizi Steeve, Kamphuis Guido, Giusti Guido, Andreassen Kim Hovgaard, Knoll Thomas, Osther Palle Jörn, Scoffone Cesare, Pérez-Fentes Daniel, Proietti Silvia, Wiseman Oliver, de la Rosette Jean, Traxer Olivier
Department of Urology, Tenon Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France.
Pierre et Marie Curie University, Paris, France.
World J Urol. 2017 May;35(5):809-818. doi: 10.1007/s00345-016-1936-x. Epub 2016 Sep 26.
We evaluated a new digital single-use flexible ureteroscope, LithoVue™ with respect to deflection, image quality and maneuverability.
A prospective cohort study was conducted in eight tertiary reference centers in Europe in December 2015 and January 2016. All consecutive patients included underwent flexible ureteroscopy and were 18 years or older. Deflection and image quality pre- and post-use and maneuverability were rated with a Likert scale.
A total of 40 procedures were performed (five per institution). The indication for FURS was treatment of renal stones in 92.5 % of the cases. Before LithoVue™ usage, the median measured upward and downward deflections were both 270°. Image quality was rated as "very good" in 65 % of cases and "good" in 30 %. Maneuverability was "very good" in 77.5 % and "good" in 17.5 %. At the final evaluation, median upward and downward deflections were both 270°. Image quality was still "very good" in 65 % of cases and "good" in 30 % with no significant difference compared with preoperative data (p = 1). Maneuverability was "very good" in 72.5 % and "good" in 17.5 %, with no significant difference compared with preoperative data (p = 0.92). Two LithoVue™ broke during surgery (5 %): one occurring in extreme deflection with acute infundibulopelvic angle and spontaneous loss of vision for the second one.
The LithoVue™ displayed good image quality, active deflection and maneuverability. Further evaluation of surgical outcomes and cost analysis will help to present the best utility of this single-use FURS in current practice.
我们对一款新型一次性使用的软性输尿管镜LithoVue™的偏转、图像质量和可操作性进行了评估。
2015年12月至2016年1月在欧洲的八个三级参考中心进行了一项前瞻性队列研究。所有纳入的连续患者均接受了软性输尿管镜检查，年龄在18岁及以上。使用前和使用后的偏转及图像质量以及可操作性采用李克特量表进行评分。
共进行了40例手术（每个机构5例）。92.5%的软性输尿管镜碎石术（FURS）病例的适应证为肾结石治疗。在使用LithoVue™之前，测量的向上和向下偏转的中位数均为270°。65%的病例图像质量被评为“非常好”，30%被评为“好”。77.5%的可操作性被评为“非常好”，17.5%被评为“好”。在最终评估时，向上和向下偏转的中位数均为270°。65%的病例图像质量仍为“非常好”，30%为“好”，与术前数据相比无显著差异（p = 1）。72.5%的可操作性为“非常好”，17.5%为“好”，与术前数据相比无显著差异（p = 0.92）。两台LithoVue™在手术过程中损坏（5%）：一台在极度偏转且肾盂漏斗角尖锐时发生，另一台出现视力自发丧失。
LithoVue™显示出良好的图像质量、主动偏转和可操作性。对手术结果的进一步评估和成本分析将有助于展现这款一次性使用的软性输尿管镜碎石术在当前实践中的最佳效用。
