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吸力反馈式柔性输尿管镜下智能控压碎石术治疗上尿路结石即刻清石率高。

High stone-free rate immediately after suctioning flexible ureteroscopy with Intelligent pressure-control in treating upper urinary tract calculi.

机构信息

Department of Urology, The General Hospital of Fujian Energy Group, No.18 Houxian Road, Fuzhou, 350003, Fujian Province, People's Republic of China.

出版信息

BMC Urol. 2022 Nov 10;22(1):180. doi: 10.1186/s12894-022-01126-0.

DOI:10.1186/s12894-022-01126-0
PMID:36357903
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9650831/
Abstract

BACKGROUND

The retrospective observational study aimed to evaluate the safety and efficacy of suctioning flexible ureteroscopy with Intelligent pressure-control (SFUI) on treating upper urinary tract calculi in a large cohort.

METHODS

Between July 2020 and August 2021, 278 patients with upper urinary tract calculi who underwent SFUI in our hospital were enrolled. Outcomes were stone-free rate (SFR) in one session and one-month after SFUI treatment, and complications scored by the Clavien-Dindo classification.

RESULTS

A total of 310 kidneys underwent SFUI were included. The median surgery time was 75 min (ranged 60-110 min). One session and one-month SFRs were 80.65% and 82.26%, respectively. The one-session SFR was ≧ 87% in patients with Guy's stone score of Grade I among stone size < 40 mm. Risk factors for unsuccessful stone-free in one session were stone history (adjusted odds ratio (aOR): 2.39, 95% confidence interval (CI): 1.21-4.73), stone size of 40-49 mm (aOR: 4.37, 95% CI: 1.16-16.45), Guy's stone score ≧ Grade II (Grade II, aOR: 3.54, 95% CI: 1.18-10.59; Grade III, aOR: 10.95, 95% CI: 2.65-45.25). The incidence of Clavien-Dindo grade II-III complication was 3.26%. Complication is associated with Guy's stone score III (aOR: 22.36, 95% CI: 1.81-276.36).

CONCLUSION

SFUI shows good safety and efficiency on treating upper urinary tract calculi. Patients with stone size < 40 mm or Guy's stone score of Grade I have a high chance to reach stone-free after SFUI treatment.

摘要

背景

本回顾性观察研究旨在评估智能压力控制下输尿管镜碎石术（SFUI）治疗上尿路结石的安全性和有效性。

方法

2020 年 7 月至 2021 年 8 月，278 例上尿路结石患者在我院接受 SFUI 治疗，评估结石清除率（SFR）、术后并发症。

结果

共 310 例肾脏接受 SFUI 治疗，手术时间中位数为 75 分钟（60-110 分钟）。一期和术后 1 个月的 SFR 分别为 80.65%和 82.26%。结石大小<40mm、Guy 结石评分Ⅰ级患者的一期 SFR 为≧87%。一期结石清除失败的危险因素为结石史（调整比值比（aOR）：2.39，95%置信区间（CI）：1.21-4.73）、结石大小为 40-49mm（aOR：4.37，95%CI：1.16-16.45）、Guy 结石评分≧Ⅱ级（Ⅱ级，aOR：3.54，95%CI：1.18-10.59；Ⅲ级，aOR：10.95，95%CI：2.65-45.25）。Clavien-Dindo Ⅱ-Ⅲ级并发症发生率为 3.26%。并发症与 Guy 结石评分Ⅲ级相关（aOR：22.36，95%CI：1.81-276.36）。

结论

SFUI 治疗上尿路结石安全有效，结石大小<40mm 或 Guy 结石评分Ⅰ级患者行 SFUI 治疗后有较高的结石清除率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34e7/9650831/aca96baaf1ae/12894_2022_1126_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34e7/9650831/aca96baaf1ae/12894_2022_1126_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34e7/9650831/aca96baaf1ae/12894_2022_1126_Fig1_HTML.jpg

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