Bozzini G, Bevilacqua L, Besana U, Calori A, Pastore A, Romero Otero J, Macchi A, Broggini P, Breda A, Gozen A, Inzillo R, Puliatti S, Sighinolfi M C, Rocco B, Liatsikos E, Muller A, Buizza C
ESUT, European section for UroTechnology EAU, Arnhem, Países Bajos; Urology Department, ASST Valle Olona, Busto Arsizio, Lombardía, Italia.
Urology Department, Baggiovara Hospital, Módena, Italia.
Actas Urol Esp (Engl Ed). 2021 Jul 31. doi: 10.1016/j.acuro.2020.11.010.
To compare intraoperative ureteral injuries in RIRS with UAS insertion with the rate of postoperative infections after RIRS without UAS insertion.
In this randomized trial, patients who received an indication for RIRS between January 2017 and December 2017 were divided into two groups. Group A had no UAS insertion and Group B had UAS insertion. Post-Ureteroscopic Lesion Scale (PULS) grading was performed after UAS or flexible ureteroscope removal. Proximal, middle and distal ureteral lesions were evaluated and compared according to the PULS scale. Additionally, patients in both groups were followed postoperatively to assess any infective complication.
The evaluation comprised 181 patients, 89 for group A and 92 for group B. Overall stone-free rate, clinically insignificant residual fragments, and final stone-free rate were 41.4%, 53.5%, and 95%, respectively. There were 33 (37.1%) patients with ureteral lesions in group A while 42 (45.6%) patients had ureteral lesions in group B, with no significant difference. On the other hand, the overall presence of postoperative infection rate was much higher for Group A (37.1% vs 16.3% P=.03).
UAS insertion does not result in a higher number of ureteral injuries. UAS insertion during RIRS allows a lower rate of postoperative infections. Clinical Trial Registration Number (ISRCTN registry number): 55546280.
比较逆行肾内手术（RIRS）中输尿管软镜鞘（UAS）置入导致的术中输尿管损伤与未置入UAS的RIRS术后感染率。
在这项随机试验中，将2017年1月至2017年12月期间接受RIRS适应证的患者分为两组。A组未置入UAS，B组置入UAS。在拔除UAS或软性输尿管镜后进行输尿管镜术后损伤量表（PULS）分级。根据PULS量表评估和比较输尿管近端、中段和远端病变。此外，对两组患者进行术后随访，以评估任何感染性并发症。
该评估纳入了181例患者，A组89例，B组92例。总体无石率、临床无意义残留碎片率和最终无石率分别为41.4%、53.5%和95%。A组有33例（37.1%）患者发生输尿管病变，B组有42例（45.6%）患者发生输尿管病变，差异无统计学意义。另一方面，A组术后感染率总体更高（37.1%对16.3%，P = 0.03）。
置入UAS不会导致更多的输尿管损伤。RIRS期间置入UAS可降低术后感染率。临床试验注册号（ISRCTN注册号）：55546280。
