METHODS: In this randomized trial, patients who received an indication for RIRS between January 2017 and December 2017 were divided into two groups. Group A had no UAS insertion and Group B had UAS insertion. Post-Ureteroscopic Lesion Scale (PULS) grading was performed after UAS or flexible ureteroscope removal. Proximal, middle and distal ureteral lesions were evaluated and compared according to the PULS scale. Additionally, patients in both groups were followed postoperatively to assess any infective complication.
RESULTS: The evaluation comprised 181 patients, 89 for group A and 92 for group B. Overall stone-free rate, clinically insignificant residual fragments, and final stone-free rate were 41.4%, 53.5%, and 95%, respectively. There were 33 (37.1%) patients with ureteral lesions in group A while 42 (45.6%) patients had ureteral lesions in group B, with no significant difference. On the other hand, the overall presence of postoperative infection rate was much higher for Group A (37.1% vs 16.3% P=.03).
CONCLUSIONS: UAS insertion does not result in a higher number of ureteral injuries. UAS insertion during RIRS allows a lower rate of postoperative infections. Clinical Trial Registration Number (ISRCTN registry number): 55546280.
方法:在这项随机试验中,在2017年1月至2017年12月期间接受RIRS适应证的患者被分为两组.A组无UAS插入,B组无UAS插入。在UAS或输尿管软镜切除后进行输尿管镜后病变量表(PULS)分级。近端,根据PULS量表对输尿管中段和远端病变进行评估和比较。此外,两组患者术后均接受随访,以评估任何感染性并发症.
结果:评估包括181名患者,A组89例,B组92例。总体无石率,临床上微不足道的残留碎片,最终无结石率为41.4%,53.5%,95%,分别。A组输尿管病变33例(37.1%),B组输尿管病变42例(45.6%)。没有显著差异。另一方面,A组患者术后感染率总体较高(37.1%vs16.3%P=.03).
结论:插入UAS不会导致更多的输尿管损伤。在RIRS期间插入UAS可以降低术后感染率。临床试验登记号(ISRCTN登记号):55546280。