1 Sorbonne University , GRC n°20 RENAL LITHIASIS, AP-HP, Tenon Hospital, F-75020, Paris, France .
2 Department of Urology, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico - Università degli Studi di Milano , Milan, Italy .
J Endourol. 2018 Jun;32(6):523-528. doi: 10.1089/end.2017.0838. Epub 2018 Apr 24.
Flexible ureterorenoscopy (fURS) is one of the best solutions for treatment of renal calculi <2 cm and for upper urinary tract urothelial carcinoma conservative treatment. An adequate quality of vision is mandatory to help surgeon get better outcomes. No studies have been done, to our knowledge, about what fURS in the market has the best quality of vision.
Seven different fURS were used to compare the image quality (Lithovue, Olympus V, Olympus V2, Storz Flex XC-in White Light and in Clara+Chroma mode-Wolf Cobra Vision, Olympus P6, and Storx Flex X2). Two standardized grids to evaluate contrast and image definition and three stones of different composition were filmed in four standardized different scenarios. These videos were shown to 103 subjects (51 urologists and 52 nonurologists) who had to evaluate them with a rating scale from 1 (very bad) to 5 (very good).
No difference in terms of scores was observed for sex of the participants. Digital (D) ureterorenoscopes were rated better than fiber optics (FOs) ureterorenoscopes. Overall, Flex XC White Light and XC Clara+Chroma image quality resulted steadily better than other fURS (p < 0.0001). Olympus V generally provided a vision better than Lithovue. Cobra Vision and Olympus V2 had superimposable values that were significantly lower than Lithovue's ones. Olympus P6 and Storz X2 offered a low quality of vision compared to the others. In the medium simulating bleeding, Olympus V and V2 significantly improved their scores of 12% and 8.1%, contrary to rest of the ureterorenoscopes.
D ureterorenoscopes have a better image quality than FO ones. The only disposable ureterorenoscope tested was comparable to the majority of other D ureterorenoscopes. The best image quality was provided by Storz D ureterorenoscopes, being Clara Chroma the favorite Spies Mode, according to literature.
软性输尿管镜检查术（fURS）是治疗<2cm 肾结石和上尿路尿路上皮癌保守治疗的最佳方法之一。为了帮助外科医生获得更好的结果，清晰的视野质量是必不可少的。据我们所知，目前还没有研究针对市场上哪种 fURS 具有最佳的视觉质量。
使用七种不同的 fURS 来比较图像质量（Lithovue、Olympus V、Olympus V2、Storz Flex XC-白光和 Clara+Chroma 模式-Wolf Cobra Vision、Olympus P6 和 Storx Flex X2）。使用两个标准化网格来评估对比度和图像清晰度，并用不同组成的三颗石头在四个标准化不同场景下进行拍摄。这些视频展示给 103 名受试者（51 名泌尿科医生和 52 名非泌尿科医生），他们必须使用 1 到 5 的评分标准进行评估。
参与者的性别在评分方面没有差异。数字（D）输尿管镜比纤维光学（FO）输尿管镜的评分更高。总体而言，Flex XC 白光和 XC Clara+Chroma 的图像质量始终优于其他 fURS（p<0.0001）。Olympus V 通常提供比 Lithovue 更好的视觉效果。Cobra Vision 和 Olympus V2 的值可叠加，明显低于 Lithovue 的值。Olympus P6 和 Storz X2 与其他相比提供了低质量的视觉效果。在模拟中度出血的情况下，Olympus V 和 V2 的评分分别提高了 12%和 8.1%，而其他输尿管镜则没有提高。
D 输尿管镜比 FO 输尿管镜具有更好的图像质量。唯一测试的一次性输尿管镜与大多数其他 D 输尿管镜相当。根据文献，STORZ D 输尿管镜提供了最佳的图像质量，Clara Chroma 是最受欢迎的 Spies 模式。
