Department of Urology, The Second Hospital of Longyan, Longyan, 364000, Fujian, China.
Sci Rep. 2024 Feb 27;14(1):4745. doi: 10.1038/s41598-024-55333-w.
To compare the safety and effectiveness of the combination of intelligent intrarenal pressure control platforms (IPCP) and flexible ureteral access sheath (FUAS) combined with retrograde intrarenal surgery (RIRS) for the treatment of renal stones less than 2 cm. We retrospectively collected 383 patients with renal stones who underwent RIRS in our department from June 2022 to October 2023. Inclusion criteria: stone length or the sum of multiple stone lengths ≤ 2 cm. Finally, 99 cases were included and divided into an IPCP group (n = 40) and FUAS group (n = 59) based on surgical methods. The main endpoint was the stone-free rate (SFR) at third months after surgery, with no residual stones or stone fragments less than 2 mm defined as stone clearance. The secondary endpoints were surgical time and perioperative complications, including fever, sepsis, septic shock, and perirenal hematoma. There was no statistically significant difference in general information between the two groups, including age, gender, body mass index, comorbidities, stone side, stone location, stone length, urine bacterial culture, and hydronephrosis. The operation time for IPCP group and FUAS group was 56.83 ± 21.33 vs 55.47 ± 19.69 min (p = 0.747). The SFR of IPCP group and FUAS group on the first postoperative day was 75.00% vs 91.50% (p = 0.024). The SFR was 90.00% vs 94.90% in the third month (p = 0.349).In IPCP group, there were 11 cases with stones located in the lower renal calyces and 17 cases in FUAS group. The SFR of the two groups on the first day and third months after surgery were 45.50% vs 88.20% (p = 0.014) and 63.60% vs 94.10% (p = 0.040), respectively, with statistical differences. For kidney stones ≤ 2 cm, there was no difference in SFR and the incidence of infection-related complications between IPCP and FUAS combined with RIRS, both of which were superior to T-RIRS. For lower renal caliceal stones, FUAS has a higher SFR compared to IPCP.
比较智能肾内压力控制平台（IPCP）和柔性输尿管镜鞘（FUAS）联合逆行肾内手术（RIRS）治疗肾结石小于 2cm 的安全性和有效性。我们回顾性收集了 2022 年 6 月至 2023 年 10 月在我科行 RIRS 的 383 例肾结石患者，纳入标准：结石长度或多个结石长度之和≤2cm。最终纳入 99 例，根据手术方法分为 IPCP 组（n=40）和 FUAS 组（n=59）。主要终点为术后 3 个月结石清除率（SFR），无残留结石或结石碎片小于 2mm 定义为结石清除。次要终点为手术时间和围手术期并发症，包括发热、脓毒症、感染性休克和肾周血肿。两组一般资料比较，包括年龄、性别、体重指数、合并症、结石侧、结石位置、结石长度、尿细菌培养和肾积水，差异无统计学意义。IPCP 组和 FUAS 组的手术时间分别为 56.83±21.33 分钟和 55.47±19.69 分钟（p=0.747）。术后第 1 天 IPCP 组和 FUAS 组的 SFR 分别为 75.00%和 91.50%（p=0.024）。术后第 3 个月 SFR 分别为 90.00%和 94.90%（p=0.349）。在 IPCP 组中，有 11 例结石位于下盏，FUAS 组中有 17 例。两组术后第 1 天和第 3 个月的 SFR 分别为 45.50%和 88.20%（p=0.014）和 63.60%和 94.10%（p=0.040），差异有统计学意义。对于肾结石≤2cm，IPCP 和 FUAS 联合 RIRS 的 SFR 和感染相关并发症的发生率无差异，均优于 T-RIRS。对于下盏结石，FUAS 的 SFR 高于 IPCP。
