目的:这项研究评估了在输尿管软镜(fURS)中使用入路鞘(AS)治疗尿石症的影响,关注无石率等结果,操作时间,和并发症。
方法:这种前瞻性,随机研究在Badr医院进行,赫尔万大学,和AinShams大学医院从2021年8月到2022年8月。患者被系统随机分为两组(fURS伴AS:33例,无AS:31例),并接受术前和术后评估,包括实验室测试和成像。可能的程序相关风险,例如失败的石头访问,疼痛,出血,和败血症,被监控。
结果:发现两组在人口统计学特征或术前结石发现方面具有可比性(均p>0.05)。然而,无鞘组手术时间较短(79.4±15.3分钟vs.鞘组90.4±16.7分钟,p=0.008)。术中并发症发生率,包括失败的访问,操作终止,输尿管损伤,流血,两组具有可比性(p>0.05)。术后结石清除率(78.8%vs.71.0%,p=0.305)和平均残余结石尺寸(2.7±3.5mmvs.3.1±3.1mm,p=0.687)显示无显著差异。
结论:本研究表明,没有入路鞘的fURS可能为处理输尿管上段和肾结石提供一种有效且同样有效的选择。然而,需要更多样本量更大、随访时间更长的研究来验证这些发现,并为该方法建立更精确的适应症.
OBJECTIVE: This
study evaluates the impact of using an access sheath (AS) during flexible ureteroscopy (fURS) for urolithiasis treatment, focusing on outcomes such as stone-free rate, operation time, and complications.
METHODS: This prospective, randomized
study was carried out at Badr Hospital, Helwan University, and Ain Shams University hospitals from August 2021 to August 2022. Patients were systematically randomized into two groups (fURS with AS: 33 patients and without AS: 31 patients) and underwent preoperative and postoperative assessments, including lab tests and imaging. Possible procedure-associated risks, such as failed stone access, pain, bleeding, and sepsis, were monitored.
RESULTS: The two groups were found to be comparable in terms of demographic characteristics or preoperative stone findings (p > 0.05 for all). However, operation duration was shorter in the No Sheath group (79.4 ± 15.3 min vs. 90.4 ± 16.7 min in the Sheath group, p = 0.008). Intraoperative complication rates, including failed access, operation termination, ureteric injury, and bleeding, were comparable in both groups (p > 0.05). Postoperative stone-free rates (78.8% vs. 71.0%, p = 0.305) and mean residual stone size (2.7 ± 3.5 mm vs. 3.1 ± 3.1 mm, p = 0.687) showed no significant differences.
CONCLUSIONS: The present
study suggests that fURS without an access sheath may offer an efficient and equally effective option for managing upper ureteric and renal stones. However, more studies with larger sample sizes and longer follow-up periods are required to validate these findings and to establish more precise indications for this approach.