Urology Division, Sheng Jing Hospital, China Medical University, Shenyang, 110000, China.
World J Urol. 2021 Nov;39(11):4261-4265. doi: 10.1007/s00345-021-03722-5. Epub 2021 May 17.
To investigate the clinical efficacy of a novel vacuum suction ureteroscopic approach in the treatment of upper ureteral calculi and to compare it with traditional rigid and flexible ureteroscopic approaches.
A total of 160 patients with impacted upper ureteral calculi were included in this study. 50 patients underwent rigid ureteroscopic lithotripsy, 54 patients underwent flexible ureteroscopic lithotripsy, and 56 patients underwent vacuum suction ureteroscopic lithotripsy. The operative time, length of hospitalization, stone-free rate, the incidence of postoperative complications, and total treatment cost were compared among the three groups. Subgroup analysis was performed based on the stone diameter over and below 1.5 cm.
All operations were performed successfully, and there were no cases converted to open surgery. Compared with the other 2 groups, the vacuum suction ureteroscopy group had a higher stone-free rate at 3-5 days (90.0% vs. 61.9% vs. 55.6%, P < 0.05) and 1 month (96.4% vs. 77.7% vs. 74.0%, P < 0.05) postoperatively. In subgroup analysis, the stone-free rate of the vacuum suction ureteroscopy group was significantly higher when the stone diameter was > 1.5 cm at 1 month postoperatively (P < 0.05) compared with that in the other 2 groups; however, there were no differences in postoperative complications. (P > 0.05).
The novel vacuum suction ureteroscopic lithotripsy has significantly improved the stone-free rate especially in complicated cases, compared with that in rigid and flexible approaches; however, the complication and cost were not increased.
探讨新型真空抽吸输尿管镜治疗输尿管上段结石的临床疗效，并与传统的硬性和软性输尿管镜方法进行比较。
本研究共纳入 160 例嵌顿性输尿管上段结石患者。50 例患者接受硬性输尿管镜碎石术，54 例患者接受软性输尿管镜碎石术，56 例患者接受真空抽吸输尿管镜碎石术。比较三组患者的手术时间、住院时间、结石清除率、术后并发症发生率和总治疗费用。根据结石直径>1.5cm 和≤1.5cm 进行亚组分析。
所有手术均成功完成，无中转开放手术病例。与其他两组相比，真空抽吸输尿管镜组在术后 3-5 天（90.0%比 61.9%比 55.6%，P<0.05）和 1 个月（96.4%比 77.7%比 74.0%，P<0.05）的结石清除率更高。在亚组分析中，当结石直径>1.5cm 时，真空抽吸输尿管镜组在术后 1 个月的结石清除率明显高于其他两组（P<0.05）；然而，术后并发症无差异（P>0.05）。
与硬性和软性方法相比，新型真空抽吸输尿管镜碎石术显著提高了结石清除率，尤其是在复杂病例中；然而，并未增加并发症和费用。
