School of the Second Clinical Medical College, Zhejiang Chinese Medical University.
First People's Hospital of Fuyang.
Int J Surg. 2024 Jul 1;110(7):4320-4328. doi: 10.1097/JS9.0000000000001345.
Upper urinary tract stones are a common urological disease that can be treated by flexible ureteroscopy (FURS) through the natural urinary tract, in addition to extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy. The advantages of FURS are less trauma, faster recovery, and fewer complications, while its disadvantages include poor results of lithotripsy and stone extraction when dealing with larger stones, and prolonged operation time. Over the last two decades, the emergence of new technologies such as FURS combined with negative pressure suction, robot-assisted FURS, and artificially intelligent FURS, coupled with improvements in laser technology (the use of thulium fiber lasers and the invention of single-use flexible ureteroscopes (su-fURS) suitable for primary level application, have significantly increased the global adoption of FURS. This surge in usage holds a promising future in clinical application, benefiting a growing number of patients with renal calculi. Accompanied by changes in technical concepts and therapeutic modalities, the scope of indications for FURS is broadening, positioning it as a potential primary choice for urolithiasis treatment in the future. This review outlines the progress in employing FURS for the treatment of renal calculi in order to generate insights for further research.
上尿路结石是一种常见的泌尿外科疾病,可通过经自然腔道的输尿管软镜(FURS)治疗,此外还包括体外冲击波碎石术和经皮肾镜取石术。FURS 的优点是创伤较小、恢复较快、并发症较少,但其缺点包括在处理较大结石时碎石和取石效果较差,以及手术时间延长。在过去的二十年中,新技术的出现,如结合负压吸引的 FURS、机器人辅助 FURS 和人工智能 FURS,再加上激光技术的改进(使用铥光纤激光和发明适用于基层应用的一次性使用输尿管软镜(su-FURS)),显著增加了 FURS 在全球的应用。这种使用的激增在临床应用中有着广阔的前景,使越来越多的肾结石患者受益。随着技术概念和治疗方式的变化,FURS 的适应证范围不断扩大,将其定位为未来治疗尿石症的潜在首选方法。本综述概述了 FURS 治疗肾结石的进展,以期为进一步的研究提供思路。