Department of Urology, Beijing Electric Power Hospital, SGCC (State Gird Corporation of China), Beijing, China.
Urol Int. 2021;105(7-8):587-593. doi: 10.1159/000512054. Epub 2021 May 5.
The aim of the study was to compare the efficiency and clinical outcomes of Moses contact mode (MCM) and regular dusting mode (RDM) during flexible ureteroscopic lithotripsy (FURL) for treatment of renal calculus.
This retrospective analysis examined 216 patients with renal calculus who underwent FURL with MCM or RDM between March 2015 and January 2020. Stone characteristics, including size, volume, and density, were collected. Laser parameters, including laser type, laser working time, laser pause time, and foot-pedal use, were automatically recorded by the lithotripter work panel. The percentages of laser working time and laser pause time, stone fragmentation efficiency (SFE; volume/laser working time), postoperative complications, including fever and acute renal failure (ARF), stone-free rate (SFR), and the need for auxiliary procedures were determined.
There were no significant differences in preoperative demographic and stone characteristics between the MCM group and the RDM group. The MCM group had a shorter laser working time (4.99 ± 1.06 vs. 5.94 ± 0.96 min, p < 0.001) and a greater SFE (137.86 [163.78-114.38] versus 114.94 [132.06-101.34] mm3/min, p < 0.001), which shortened the overall operative time (18.39 ± 5.13 vs. 21.17 ± 6.78 min, p = 0.001). There were no differences in postoperative complications, including fever and ARF, SFR (86.8 vs. 85.3%, p = 0.743), and auxiliary procedures between the 2 groups.
Using Moses laser technology with FURL significantly reduced laser working time and increased SFE, which shortened overall operative time. Urologists should consider this new instrument for the clinical management of renal calculus.
本研究旨在比较摩西接触模式（MCM）和常规撒粉模式（RDM）在经软性输尿管镜碎石术（FURL）治疗肾结石中的效率和临床结果。
本回顾性分析纳入了 2015 年 3 月至 2020 年 1 月期间采用 MCM 或 RDM 行 FURL 的 216 例肾结石患者。收集结石特征，包括大小、体积和密度。激光参数，包括激光类型、激光工作时间、激光暂停时间和脚踏使用情况，由碎石机工作面板自动记录。计算激光工作时间和激光暂停时间的百分比、结石粉碎效率（SFE；体积/激光工作时间）、术后并发症（包括发热和急性肾衰竭（ARF））、结石清除率（SFR）以及需要辅助治疗的情况。
MCM 组和 RDM 组患者的术前人口统计学和结石特征无显著差异。MCM 组激光工作时间更短（4.99 ± 1.06 比 5.94 ± 0.96 min，p < 0.001），SFE 更高（137.86 [163.78-114.38] 比 114.94 [132.06-101.34] mm3/min，p < 0.001），总手术时间更短（18.39 ± 5.13 比 21.17 ± 6.78 min，p = 0.001）。两组术后并发症（包括发热和 ARF）、SFR（86.8%比 85.3%，p = 0.743）和辅助治疗无差异。
在 FURL 中使用摩西激光技术可显著减少激光工作时间并提高 SFE，从而缩短总手术时间。泌尿科医生应考虑将这种新仪器用于肾结石的临床治疗。
