两种方法在软性输尿管镜碎石术中取石碎片的结果比较。
Comparison of Outcomes between Two Methods to Extract Stone Fragments during Flexible Ureteroscopic Lithotripsy.
机构信息
Department of Urology, Yokosuka Kyosai Hospital, 1-16 Yonegahama-Dori, Yokosuka, Kanagawa, Japan.
Department of Urology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan.
出版信息
Biomed Res Int. 2018 May 30;2018:4526721. doi: 10.1155/2018/4526721. eCollection 2018.
OBJECTIVES
To retrospectively compare the operative and clinical outcomes of flexible ureteroscopic lithotripsy (fURSL) with stone extraction performed either by a surgeon (SE) who manipulates the retrieval basket or by having the surgical assistant (AE) manipulate the retrieval basket with the aim of clarifying which method provides a greater stone-free postoperative status.
METHODS
The study group consisted of patients who underwent fURSL with SE or AE at our institution between April 2015 and December 2016. Demographic, clinical, stone, and operative variables were compared between the two groups. Multivariate logistic regression was used to identify risk factors associated with a stone-free and non-stone-free status postoperatively.
RESULTS
Our analysis included 196 cases of renal stones treated using fURSL, with 109 who underwent AE and 87 who underwent SE. The rate of stone-free status was higher for the SE group (90.8%) than for the AE group (61.5%; < 0.001). The method of extraction was identified as an independent predictor of stone-free status ( < 0.001, odds ratio (SE compared to AE), 9.133, 95% confidence interval, 3.736-22.322).
CONCLUSION
The stone-free rate is improved by having the surgeon perform the stone extraction as part of the fURSL procedure.
目的
回顾性比较由术者（SE）操作取石篮或由手术助手（AE）操作取石篮进行软性输尿管镜碎石术（fURSL）的手术和临床效果，旨在阐明哪种方法能提供更好的术后无结石状态。
方法
本研究纳入 2015 年 4 月至 2016 年 12 月在我院行 fURSL 的患者，比较两组患者的人口统计学、临床、结石和手术变量。采用多因素逻辑回归分析确定与术后无结石和有结石状态相关的危险因素。
结果
我们的分析包括 196 例肾结石患者，其中 109 例采用 AE 方法，87 例采用 SE 方法。SE 组的无结石状态率（90.8%）高于 AE 组（61.5%；<0.001）。取石方法是无结石状态的独立预测因素（<0.001，优势比（SE 与 AE 相比），9.133，95%置信区间，3.736-22.322）。
结论
在 fURSL 手术中由术者进行取石可提高无结石率。
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