ESUT, European Section for UroTechnology EAU, Arnhem, The Netherlands; Urology Department, ASST Valle Olona, Busto Arsizio, Lombardía, Italy.
Urology Department, Baggiovara Hospital, Módena, Italy.
Actas Urol Esp (Engl Ed). 2021 Nov;45(9):576-581. doi: 10.1016/j.acuroe.2020.11.010. Epub 2021 Oct 23.
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 = 0.03).
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.
比较输尿管镜碎石术（RIRS）联合输尿管软镜鞘（UAS）置入与单纯 RIRS 术后感染率。
这是一项随机试验，将 2017 年 1 月至 12 月期间接受 RIRS 治疗的患者分为两组。A 组未置入 UAS，B 组置入 UAS。在 UAS 或软性输尿管镜取出后进行输尿管镜术后损伤分级（PULS）。根据 PULS 分级评估和比较近端、中段和远端输尿管损伤。此外，两组患者术后均进行随访，以评估任何感染性并发症。
共纳入 181 例患者，A 组 89 例，B 组 92 例。总体结石清除率、临床无意义残留碎片和最终结石清除率分别为 41.4%、53.5%和 95%。A 组 33 例（37.1%）患者出现输尿管损伤，B 组 42 例（45.6%）患者出现输尿管损伤，差异无统计学意义。另一方面，A 组术后感染总发生率明显更高（37.1%比 16.3%，P=0.03）。
UAS 置入并不会导致更多的输尿管损伤。RIRS 中置入 UAS 可降低术后感染率。
临床试验注册号（ISRCTN 注册号）：55546280。
