Agrawal Shashank, Survase Pavan, Singh Abhishek G, Ganpule Arvind P, Sabnis Ravindra B, Desai Mahesh R
Department of Urology, Muljibhai Patel Urological Hospital, Dr Virendra Desai Road, Nadiad, Gujarat, 387991, India.
World J Urol. 2023 Oct;41(10):2817-2821. doi: 10.1007/s00345-023-04532-7. Epub 2023 Aug 6.
A single-use digital flexible ureteroscope (fURS) has become a cost-effective alternative option to reusable fURS. The requirement of large-diameter access sheath for passage of 9.5 Fr single-use fURS has not always achieved in the first attempt in all cases leading to stage stone clearance. Recently, two slimmest single-use digital disposable fURSs have been introduced by Bioradmedisys™ and Pusen™ to mitigate the accessibility problem, without or with small size access sheath. Primary objective was to compare in vivo performance and surgical outcomes with two single-use fURS: 7.5Fr Indoscope (Bioradmedisys™, Pune, India) and 7.5Fr Uscope PU3033A (Pusen, Zhuhai, China).
60 patients undergoing Retrograde Intrarenal Surgery (RIRS) with < 2 cm renal stones were prospectively randomized into: Group A (30 patients) for Indoscope and Group B (30 patients) for Uscope PU3033A. Pre-operative, intra-operative, and post-operative parameters were evaluated. In vivo visibility and maneuverability were rated on 5-point Likert scale by the operating surgeon. At one-month stone clearance was assessed with ultrasound and X-ray KUB. Data were analyzed using SPSS 23.0.
Patient demographics and stone characteristics were comparable in both groups. Indoscope had significantly higher visibility (p < 0.05) than Uscope; however, the maneuverability scores were comparable between both the groups (p > 0.05). 28 patients in group A and 26 patients in group B achieved complete stone clearance (p = 0.38). Scope failure was observed in 1 case of group B (p = 0.31).
We conclude that 7.5Fr Indoscope has better vision than 7.5Fr Uscope and the rest of in vivo performances were comparable with similar outcomes and complications among both scopes.
一次性使用的数字柔性输尿管镜(fURS)已成为可重复使用fURS的一种经济高效的替代选择。在所有导致结石清除的病例中,并非总能在首次尝试时就成功实现用于9.5 Fr一次性使用fURS通过的大直径接入鞘的需求。最近,Bioradmedisys™和普森™推出了两款最细的一次性使用数字式一次性fURS,以缓解可及性问题,分别是无需或使用小尺寸接入鞘的情况。主要目的是比较两款一次性使用fURS(7.5Fr Indoscope,Bioradmedisys™,印度浦那;7.5Fr Uscope PU3033A,普森,中国珠海)的体内性能和手术结果。
60例肾结石<2 cm且接受逆行性肾内手术(RIRS)的患者被前瞻性随机分为:A组(30例患者)使用Indoscope,B组(30例患者)使用Uscope PU3033A。对术前、术中和术后参数进行评估。手术医生使用5分李克特量表对体内视野和可操作性进行评分。术后1个月通过超声和X线腹部平片评估结石清除情况。使用SPSS 23.0对数据进行分析。
两组患者的人口统计学特征和结石特征具有可比性。Indoscope的视野明显高于Uscope(p<0.05);然而,两组之间的可操作性评分具有可比性(p>0.05)。A组28例患者和B组26例患者实现了结石完全清除(p=0.38)。B组有1例出现镜体故障(p=0.31)。
我们得出结论,7.5Fr Indoscope的视野优于7.5Fr Uscope,且两款输尿管镜的其他体内性能具有可比性,结石清除结果和并发症相似。