Kafkas University, Kars, Turkey.
Sancaktepe Şehit Prof Dr Ilhan Varank Training and Research Hospital, Istanbul, Turkey.
Urolithiasis. 2023 Aug 9;51(1):100. doi: 10.1007/s00240-023-01478-8.
Given the limited data on the predictive factors of residual kidney stone size after flexible ureteroscopy (fURS), this study aims to investigate the variables affecting residual stone size. The medical records of 642 patients without complications being treated for kidney stones with fURS between July 2014 and May 2022 were reviewed retrospectively, and the information of the 170 patients in whom residual stones were found was recorded. In addition to patient-specific factors and stone characteristics, length of postoperative hospital stay, postoperative fever, and preoperative antiaggregant use were evaluated. Of the 170 patients ultimately included in the study. The mean age was 51.56 (± 14.70). The mean stone size was 14.01 mm (± 5.75), the mean residual stone size was 7.04 mm (± 2.51), and the mean stone density was 829 Hounsfield units (± 395.06). The mean infundibulopelvic angle (IPA) was 49.37º (± 15.37), and 41.2% of the stones were non-opaque. The mean parenchymal thickness was 22.88 mm (± 5.55). 34 patients were on antiaggregant therapy. Preoperative stone size increases in stone density and decreases in IPA were found to be correlated with increase residual stone size (p < 0.001, p < 0.001, and p < 0.001, respectively). In addition, larger residual stones were observed after the fURS procedure in patients using anticoagulants and those without hydronephrosis (p = 0.02 and p = 0.016, respectively). Use of reliable predictive factors to forecast residual stone size after fURS may help to inform those treated and enable urologists to design rational surgical strategies.
鉴于软性输尿管镜检查（fURS）后残余肾结石大小预测因素的有限数据，本研究旨在探讨影响残余结石大小的变量。回顾性分析 2014 年 7 月至 2022 年 5 月期间因肾结石接受 fURS 治疗且无并发症的 642 例患者的病历，记录发现残余结石的 170 例患者的信息。除患者特定因素和结石特征外，还评估了术后住院时间、术后发热和术前抗聚集剂使用情况。在最终纳入研究的 170 例患者中，平均年龄为 51.56（±14.70）岁。平均结石大小为 14.01mm（±5.75），平均残余结石大小为 7.04mm（±2.51），平均结石密度为 829 亨氏单位（±395.06）。平均肾盂输尿管角（IPA）为 49.37º（±15.37），41.2%的结石为非不透射线。平均肾实质厚度为 22.88mm（±5.55）。34 例患者正在接受抗聚集治疗。术前结石大小与结石密度增加和 IPA 减小与残余结石大小增加呈正相关（p<0.001、p<0.001 和 p<0.001）。此外，fURS 术后使用抗凝剂和无肾积水的患者残余结石较大（p=0.02 和 p=0.016）。使用可靠的预测因素预测 fURS 后残余结石大小可能有助于为接受治疗的患者提供信息，并使泌尿科医生能够设计合理的手术策略。
