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可弯曲头部输尿管镜吸引在肾结石治疗中的疗效与安全性

Efficacy and Safety of Tip-Flexible Suctioning Ureteral Access in Renal Stone Treatment.

作者信息

Gao Jianguo, Tang Jianer, Shen Yuefan

机构信息

Department of Urology, First Affiliated Hospital of Huzhou University, Huzhou, Zhejiang, China.

Department of Urology, The First Hospital of Huzhou, Huzhou, Zhejiang, China.

出版信息

Med Sci Monit. 2025 May 30;31:e947055. doi: 10.12659/MSM.947055.

DOI:10.12659/MSM.947055
PMID:40445880
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12131951/
Abstract

BACKGROUND We compared the efficacy and safety of a novel flexible-tip suctioning ureteral access sheath (NFTS-UAS) with flexible ureteroscopy (FURS) versus percutaneous nephrolithotomy (PCNL) for treating unilateral renal calculi (2-3.5 cm). MATERIAL AND METHODS This retrospective study included 337 patients (167 NFTS-UAS, 170 PCNL) treated at Huzhou Normal College's First Affiliated Hospital (March 2021-January 2024). Group 1 underwent FURS with NFTS-UAS, utilizing a flexible-tip sheath connected to a suction device for improved fragment clearance. Group 2 underwent standard PCNL. Outcomes included duration of surgery, stone-free rate (SFR), hospital stay, antibiotic use, and complications. RESULTS The NFTS-UAS group had shorter surgery times (80.02±29.44 vs 98.95±28.82 minutes; P<0.05) and hospital stays (45.62±30.59 vs 173.0±75.46 hours; P<0.05). Preoperative antibiotic use and postoperative infectious complications (eg, elevated neutrophils) were lower in the NFTS-UAS group. While NFTS-UAS had a lower day 1 SFR (68.26% vs 83.53%; P<0.05), SFRs had equalized by day 30 (85.0% vs 89.0%; P=0.21). No intraoperative complications occurred in either group. CONCLUSIONS NFTS-UAS with FURS is a viable alternative to PCNL for 2-3.5 cm renal stones, offering comparable 30-day SFRs, faster recovery, and reduced hospitalization. Further prospective studies are warranted to validate long-term outcomes.

摘要

背景

我们比较了一种新型柔性尖端抽吸输尿管通路鞘（NFTS-UAS）联合软性输尿管镜检查（FURS）与经皮肾镜取石术（PCNL）治疗单侧肾结石（2 - 3.5厘米）的疗效和安全性。

材料与方法

这项回顾性研究纳入了湖州师范学院第一附属医院（2021年3月至2024年1月）治疗的337例患者（167例接受NFTS-UAS治疗，170例接受PCNL治疗）。第1组采用NFTS-UAS进行FURS，使用连接抽吸装置的柔性尖端鞘以改善结石碎片清除。第2组接受标准PCNL。观察指标包括手术时间、无结石率（SFR）、住院时间、抗生素使用情况及并发症。

结果

NFTS-UAS组手术时间较短（80.02±29.44 vs 98.95±28.82分钟；P<0.05），住院时间也较短（45.62±30.59 vs 173.0±75.46小时；P<0.05）。NFTS-UAS组术前抗生素使用及术后感染并发症（如中性粒细胞升高）较少。虽然NFTS-UAS组术后第1天的SFR较低（68.26% vs 83.53%；P<0.05），但到第30天时SFR已趋于相等（85.0% vs 89.0%；P = 0.21）。两组均未发生术中并发症。

结论

对于2 - 3.5厘米的肾结石，NFTS-UAS联合FURS是PCNL的一种可行替代方案，30天SFR相当，恢复更快，住院时间缩短。需要进一步的前瞻性研究来验证长期疗效。

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本文引用的文献

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Minerva Urol Nephrol. 2024 Dec;76(6):726-735. doi: 10.23736/S2724-6051.24.06074-9.
2
Postoperative Renal Abscess Following Tip-Flexible Suctioning Ureteral Access Sheath and Digital Ureteroscopic Lithotripsy: A Case Report.经 Tip-Flexible 输尿管吸引鞘和数字输尿管镜碎石术治疗后并发的术后肾脓肿：一例报告。
Am J Case Rep. 2024 Aug 17;25:e944782. doi: 10.12659/AJCR.944782.
3
Impact of Preoperative Video-Based Education on Anxiety Levels in Patients with Renal Stones Scheduled for Flexible Ureteroscopic Lithotripsy: A Comparative Study Using APAIS and STAI.
基于视频的术前教育对拟行软性输尿管镜碎石术的肾结石患者焦虑水平的影响：采用 APAIS 和 STAI 的对比研究。
Med Sci Monit. 2023 Aug 21;29:e941351. doi: 10.12659/MSM.941351.
4
Innovations in Kidney Stone Removal.肾结石清除技术的创新。
Res Rep Urol. 2023 Apr 11;15:131-139. doi: 10.2147/RRU.S386844. eCollection 2023.
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BMC Urol. 2022 Nov 15;22(1):183. doi: 10.1186/s12894-022-01142-0.
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