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逆行性腔内手术中最细的一次性使用软性输尿管镜 Uscope PU3033A(PUSEN™)的初步经验及其与 Uscope PU3022a 的比较:单中心前瞻性研究。

Initial experience with slimmest single-use flexible ureteroscope Uscope PU3033A (PUSEN™) in retrograde intrarenal surgery and its comparison with Uscope PU3022a: a single-center prospective study.

机构信息

Muljibhai Patel Urological Hospital, Nadiad, India.

Department of Urology, Muljibhai Patel Urological Hospital, Dr. Virendra Desai Road, Nadiad, Gujarat, 387991, India.

出版信息

World J Urol. 2021 Oct;39(10):3957-3962. doi: 10.1007/s00345-021-03707-4. Epub 2021 May 10.

Abstract

PURPOSE

Single-use disposable digital flexible ureterorenoscope has become an attractive option to reusable scope with many advantages. Currently available single-use digital fURS have outer shaft diameter above 9 Fr which requires large access sheath insertion and sometimes double J stent placement. Recently, 7.5 Fr single-use digital fURS is introduced in market by Pusen. Objective of this study is to compare two Pusen single-use scopes in the clinical setting: 7.5 Fr Uscope PU3033A and 9.5 Fr Uscope PU3022A.

METHODS

30 patients, having renal stones < 2 cm, planned for RIRS were prospectively randomized to two groups: group 1 had 15 patients in which 7.5 Fr Uscope PU3033A and group 2 had 15 patients in which 9.5 Fr Uscope PU3022A was used. The various pre-operative, intra-operative, and post-operative parameters at 1 month along with complications were evaluated for both the scopes by a single surgical team.

RESULTS

Pre-operative parameters including stone characteristics were comparable in both the groups. Three patients in group 2 needed ureteric dilatation prior to 11/13 access sheath insertion, while 10/12 Fr access sheath was placed in all patients in group 1 without manipulation (p = 0.06). Intra-operative vision was comparable in both scopes with an empty working channel and with laser. Hazy vision while lasing in two and one patient in group 1 and group 2, respectively (p = 0.54). In group 1, one had fever and UTI, while in group 2, one had fever post-operatively.

CONCLUSION

7.5 Fr Uscope PU3033A could be introduced with smaller access sheath. The vision, deflection, maneuverability is comparable to 9.5 Fr Uscope PU3022a.

摘要

目的

一次性使用的数字输尿管软镜相对于可重复使用的输尿管软镜具有许多优势,已成为一种极具吸引力的选择。目前可使用的一次性数字输尿管软镜外轴直径大于 9Fr,需要插入较大的通道鞘,有时还需要放置双 J 支架。最近,品胜公司推出了外径为 7.5Fr 的一次性使用数字输尿管软镜。本研究旨在比较两种品胜一次性输尿管软镜在临床应用中的效果:7.5Fr 的 Uscope PU3033A 和 9.5Fr 的 Uscope PU3022A。

方法

前瞻性随机选择 30 例肾结石 < 2cm、计划接受 RIRS 的患者分为两组:组 1 有 15 例患者使用 7.5Fr 的 Uscope PU3033A,组 2 有 15 例患者使用 9.5Fr 的 Uscope PU3022A。由同一位手术团队评估两组患者的各种术前、术中、术后 1 个月的参数以及并发症。

结果

两组患者的术前参数(包括结石特征)均无差异。组 2 中有 3 例患者在插入 11/13 通道鞘前需要进行输尿管扩张,而组 1 中所有患者均无需操作即可插入 10/12Fr 通道鞘(p=0.06)。两组患者在使用空工作通道和激光时,软镜的术中视野均无差异。组 1 中有 2 例和 1 例患者在激光照射时出现模糊视野,组 2 中有 1 例患者出现模糊视野(p=0.54)。组 1 中有 1 例患者发热并出现尿路感染,组 2 中有 1 例患者术后发热。

结论

外径为 7.5Fr 的 Uscope PU3033A 可使用较小的通道鞘,其视野、转向和操作性与 9.5Fr 的 Uscope PU3022a 相当。

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