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可重复使用与一次性软性输尿管镜的疗效及安全性比较:多中心RIRSearch研究组的病例对照匹配结果

The comparison of efficacy and safety of reusable and disposable-flexible ureteroscopes: case-control matching results of multicentric RIRSearch study group.

作者信息

Şahin Mehmet Fatih, Dayısoylu Hulusi Sıtkı, Yazıcı Cenk Murat, Sıddıkoğlu Duygu, Çınar Önder, Akgül Murat, Çakır Hakan, Başataç Cem, Özman Oktay, Şimşekoğlu Muhammet Fatih, Teke Kerem, Tuna Mustafa Bilal, Sancak Eyüp Burak, Başeskioğlu Barbaros, Önal Bülent, Akpınar Haluk

机构信息

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

Department of Urology, Tekirdag Namık Kemal University Medical School, Tekirdag Namık Kemal University, 59020, Süleymanpaşa, Tekirdağ, Turkey.

出版信息

Int Urol Nephrol. 2025 May 13. doi: 10.1007/s11255-025-04545-8.

Abstract

PURPOSE

Today, disposable flexible ureteroscopes are increasingly used in retrograde intrarenal surgery (RIRS) as an alternative to reusable flexible ureteroscopes. The comparison of the safety and effectiveness of these two devices is still a matter of debate. This study evaluates the efficacy and safety of disposable-flexible ureteroscopes vs reusable flexible ureteroscopes in RIRS.

MATERIALS AND METHODS

The study included 1165 RIRS cases, and the patients were divided into two groups. Group 1 consisted of cases with reusable RIRS, 838 in total, while Group 2 consisted of disposable RIRS cases, 327 in total. Due to significant differences, case-control matching was performed, and subsequently, there were 229 patients in both groups. The demographic and clinical data of patients, stone characteristics, surgical data, perioperative and postoperative complications, postoperative urinary tract infection rate, duration of hospitalization, and stone-free rates (SFR) were analyzed and compared.

RESULTS

No demographic differences were observed between the two groups after case-control matching. While operative time, SFR, and postoperative infection rates were similar between the groups (p > 0.05), fluoroscopy (p = 0.001) and hospitalization (p = 0.029) times were statistically significantly lower in the disposable ureteroscopy group. Perioperative and postoperative complications were also lower in this group (p = 0.018 and p = 0.001 respectively).

CONCLUSION

Our research indicates that single-use ureteroscopes are a strong alternative to reusable ureteroscopes, demonstrating similar efficacy and reduced complication rates in the treatment of upper urinary tract stones.

摘要

目的

如今,一次性软性输尿管镜在逆行性肾内手术(RIRS)中越来越多地被用作可重复使用软性输尿管镜的替代品。这两种设备的安全性和有效性比较仍存在争议。本研究评估了一次性软性输尿管镜与可重复使用软性输尿管镜在RIRS中的疗效和安全性。

材料与方法

该研究纳入了1165例RIRS病例,患者被分为两组。第1组为可重复使用的RIRS病例,共838例,而第2组为一次性RIRS病例,共327例。由于存在显著差异,进行了病例对照匹配,随后两组各有229例患者。对患者的人口统计学和临床数据、结石特征、手术数据、围手术期和术后并发症、术后尿路感染率、住院时间以及无结石率(SFR)进行了分析和比较。

结果

病例对照匹配后,两组之间未观察到人口统计学差异。虽然两组之间的手术时间、SFR和术后感染率相似(p>0.05),但一次性输尿管镜检查组的透视时间(p = 0.001)和住院时间(p = 0.029)在统计学上显著更低。该组的围手术期和术后并发症也更低(分别为p = 0.018和p = 0.001)。

结论

我们的研究表明,一次性输尿管镜是可重复使用输尿管镜的有力替代品,在治疗上尿路结石方面显示出相似的疗效且并发症发生率更低。

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