抗反冲技术的全球应用：来自腔内泌尿外科协会输尿管镜检查全球研究临床研究办公室的观察结果
Worldwide Use of Antiretropulsive Techniques: Observations from the Clinical Research Office of the Endourological Society Ureteroscopy Global Study.
作者信息
Saussine Christian, Andonian Sero, Pacík Dalibor, Popiolek Marcin, Celia Antonio, Buchholz Noor, Sountoulides Petros, Petrut Bogdan, de la Rosette Jean J M C H
机构信息
1 Department of Urology, Nouvel Hôpital Civil les Hôpitaux Universitaires , Strasbourg, France .
2 Department of Urology, McGill University Health Centre , Quebec, Canada .
出版信息
J Endourol. 2018 Apr;32(4):297-303. doi: 10.1089/end.2017.0629. Epub 2018 Jan 17.
INTRODUCTION
Retropulsion, defined as unintended migration of a stone under the influence of the fragmentation device in ureteroscopy (URS) procedures, occurs in 2% to 60% of the cases. Antiretropulsive devices (ARDs) have been studied in experimental and small clinical studies. The current study aims at describing the worldwide usage of ARD and the outcomes related to their usage.
METHODS
The Clinical Research Office of the Endourological Society URS Global Study enrolled 11,885 patients who underwent URS and stone fragmentation for ureteral and/or renal stones. Of the 11,885 treated patients, 9877 were treated for ureteral stones, and data were available on stone migration and ARD use.
RESULTS
Of all procedures, 14.5% were performed with the use of an ARD. Less stone migration (-2.0%; p = 0.050), higher stone-free rates (SFRs) (2.8%; p < 0.001), and shorter length of stay (-4.7%; p = 0.001) were observed in the antiretropulsive group.
CONCLUSIONS
When an ARD is used during URS, less migration, higher SFRs, and shorter length of hospital stay are observed. This effect is independent from baseline differences and corrected for other treatment characteristics.
引言
输尿管镜检查（URS）过程中，结石回退是指结石在碎石设备作用下意外移位，发生率为2%至60%。抗结石回退装置（ARDs）已在实验和小型临床研究中得到研究。本研究旨在描述ARD在全球的使用情况及其使用相关的结果。
方法
腔内泌尿外科协会URS全球研究临床研究办公室纳入了11885例因输尿管和/或肾结石接受URS及结石碎石术的患者。在11885例接受治疗的患者中，9877例接受输尿管结石治疗，且有结石移位和ARD使用的数据。
结果
在所有手术中，14.5%使用了ARD。抗结石回退组观察到结石移位减少（-2.0%；p = 0.050）、无结石率（SFRs）提高（2.8%；p < 0.001）和住院时间缩短（-4.7%；p = 0.001）。
结论
在URS期间使用ARD时，观察到结石移位减少、SFRs提高和住院时间缩短。这种效果独立于基线差异，并针对其他治疗特征进行了校正。
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