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三种不同一次性输尿管镜逆行肾内手术的疗效和安全性:单中心单外科医生经验的对比分析。

The efficacy and safety of three different single-use ureteroscopes in retrograde intrarenal surgery: a comparative analysis of a single surgeon's experience in a single center.

机构信息

Faculty of Medicine, Department of Urology, Tekirdag Namık Kemal University, Süleymanpaşa, Tekirdağ, 59020, Turkey.

出版信息

World J Urol. 2024 Oct 18;42(1):583. doi: 10.1007/s00345-024-05283-9.

DOI:10.1007/s00345-024-05283-9
PMID:39422797
Abstract

PURPOSE

To evaluate and compare the clinical results of different single-use flexible ureteroscopes (su-fURS) used in retrograde intrarenal surgery (RIRS).

MATERIALS AND METHODS

RIRS cases performed identically by an experienced surgeon between 2022 and 2023 in a single center were retrospectively analyzed. These surgeries were performed with three su-fURS (Redpine RP-U-C12, Hugemed HU30, and Pusen Uscope 3022 A). In the study, the age, gender, body mass index, and Charlson comorbidity index of the patients were compared, along with their clinical details, such as the stone size, volume, density, location, and history of hydronephrosis or a double J stent or SWL. Operation time, stone-free rates (SFR), perioperative and postoperative complications, and hospitalization times were also compared.

RESULTS

The study included 208 patients. Pusen had 63 cases, Hugemed had 62, and Redpine had 83. The comparison of the patient's demographic and clinical properties with stone-related variables was similar between the groups. The SFR was similar between the groups (p = 0.056). Perioperative, postoperative, and total complication rates and the need for a second intervention showed no significant differences among the three groups (p = 0.324, 0.088, 0.061, and 0.052, respectively).

CONCLUSION

In the first study comparing the clinical results of cases in which different su-fURS were used, no difference was observed in surgical outcomes and complications, even though the technical features of these devices were different. Urologists should select su-fURS based on clinical requirements, financial constraints, and personal experiences.

摘要

目的

评估和比较不同一次性使用软性输尿管镜(su-fURS)在逆行肾内手术(RIRS)中的临床效果。

材料与方法

回顾性分析 2022 年至 2023 年期间,一位经验丰富的外科医生在同一中心进行的 RIRS 病例。这些手术使用三种 su-fURS(Redpine RP-U-C12、Hugemed HU30 和 Pusen Uscope 3022 A)进行。在研究中,比较了患者的年龄、性别、体重指数和 Charlson 合并症指数,以及他们的临床细节,如结石大小、体积、密度、位置以及肾积水、双 J 支架或 SWL 的病史。还比较了手术时间、结石清除率(SFR)、围手术期和术后并发症以及住院时间。

结果

研究纳入 208 例患者。Pusen 组 63 例,Hugemed 组 62 例,Redpine 组 83 例。各组患者的人口统计学和临床特征与结石相关变量的比较相似。各组的 SFR 相似(p=0.056)。三组之间的围手术期、术后和总并发症发生率以及需要二次干预的情况无显著差异(p=0.324、0.088、0.061 和 0.052)。

结论

在首次比较不同 su-fURS 使用病例的临床结果的研究中,尽管这些设备的技术特点不同,但手术结果和并发症没有差异。泌尿科医生应根据临床需求、经济限制和个人经验选择 su-fURS。

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本文引用的文献

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J Clin Med. 2023 Dec 13;12(24):7648. doi: 10.3390/jcm12247648.
2
An in vitro Comparative Assessment of Single-Use Flexible Ureteroscopes Using a Standardized Ureteroscopy Training Model.一种使用标准化输尿管镜培训模型的单次使用型柔性输尿管镜的体外对比评估。
Urol Int. 2022;106(12):1279-1286. doi: 10.1159/000525246. Epub 2022 Jun 16.
3
Does extracorporeal shock wave lithotripsy before retrograde intrarenal surgery complicates the surgery for upper ureter stone? The results of the RIRSearch group.
逆行性肾内手术中一次性输尿管镜未来研究的建议。
World J Urol. 2025 Apr 3;43(1):207. doi: 10.1007/s00345-025-05591-8.
体外冲击波碎石术在前逆行肾盂内手术之前是否会使输尿管上段结石的手术复杂化?RIRSearch 组的结果。
Int J Clin Pract. 2021 May;75(5):e14115. doi: 10.1111/ijcp.14115. Epub 2021 Mar 2.
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A comprehensive literature-based equation to compare cost-effectiveness of a flexible ureteroscopy program with single-use versus reusable devices.一种基于文献的综合方程,用于比较单次使用与可重复使用设备的软性输尿管镜程序的成本效益。
Int Braz J Urol. 2019 Jul-Aug;45(4):658-670. doi: 10.1590/S1677-5538.IBJU.2018.0880.
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