Karaca Yavuz, Sinanoglu Orhun, Ustun Fatih, Sahinler Emre Burak, Sahin Cahit, Sarica Kemal
Department of Urology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Research and Training Hospital, Istanbul, Turkey.
Department of Urology, Sultanbeyli State Hospital, Istanbul, Turkey.
Cent European J Urol. 2024;77(4):674-679. doi: 10.5173/ceju.2024.0053.R2. Epub 2024 Dec 27.
Ureteroscopic lithotripsy is amongst the most performed surgeries in urology practice. To achieve better results and lower complications, several approaches have been proposed. Using isothermic irrigation fluid in ureteroscopy is a novel method.The aim of this study was to show the advantages of body temperature irrigation fluid in ureteroscopy compared to room temperature fluid.
A total of 94 patients with a single ureteral stone scheduled for semirigid ureteroscopy were enrolled into this study. Patients were randomised into 2 groups: group 1, ureteroscopy with room temperature (20-22°C) irrigation fluid and group 2, ureteroscopy with body temperature (37°C) irrigation fluid. Patient characteristics, stone characteristics (stone side, stone location, stone burden, Hounsfield unit), operation outcomes (operation time, ureteral JJ stenting, complications, stone free rate after 4 weeks, auxiliary intervention, Visual Analogue Scale) were analysed.
There was no statistically significant difference between two groups regarding patient and stone characteristics. Operation time was found to be shorter in group 2 compared to group 1 (p = 0.02). Post-operative pain was also less common in group 2 compared to group 1 (p <0.001). Complication rates were 17% in group 1 and 8% in group 2 but no statistically significant difference was found.
Isothermic irrigation fluid in ureteroscopy is beneficial because: it facilitates easier ureteral access by decreasing ureteral spasms, shortens operation times, lowers post-operative pain and lowers the complications rates. This method can be used in semirigid ureteroscopy because it is an easily applicable method with no known associated complications.
输尿管镜碎石术是泌尿外科最常开展的手术之一。为了获得更好的治疗效果并降低并发症发生率,人们提出了多种方法。在输尿管镜检查中使用等温冲洗液是一种新方法。本研究的目的是展示在输尿管镜检查中,与室温冲洗液相比,体温冲洗液的优势。
本研究共纳入94例计划行半硬性输尿管镜检查的单发性输尿管结石患者。患者被随机分为两组:第1组,使用室温(20 - 22°C)冲洗液进行输尿管镜检查;第2组,使用体温(37°C)冲洗液进行输尿管镜检查。分析患者特征、结石特征(结石侧别、结石位置、结石负荷、亨氏单位)、手术结果(手术时间、输尿管双J管置入、并发症、4周后结石清除率、辅助干预、视觉模拟评分)。
两组患者和结石特征方面无统计学显著差异。发现第2组的手术时间比第1组短(p = 0.02)。与第1组相比,第2组术后疼痛也较少见(p <0.001)。第1组并发症发生率为17%,第2组为8%,但未发现统计学显著差异。
输尿管镜检查中使用等温冲洗液有益,原因如下:它通过减少输尿管痉挛便于更轻松地进入输尿管,缩短手术时间,减轻术后疼痛并降低并发症发生率。这种方法可用于半硬性输尿管镜检查,因为它是一种易于应用且无已知相关并发症的方法。