目的:比较输尿管软镜与原位碎石术治疗10-20mm下极结石(LPS)的疗效和安全性。
方法:本研究是对2020年1月至2022年11月接受FURS手术治疗10-20mm下极肾结石患者预后的前瞻性分析。患者被随机分为重新定位组或原位组。LPS被安置在花萼中,在重新定位组的碎石术中,而原位组接受了FURS而没有搬迁。所有手术均由同一外科医生进行。患者的人口统计数据,石材特性,围手术期参数和结局,无石率(SFR),并发症,和总体成本进行回顾性评估.
结果:本研究共纳入90例患者(每组45例),两组在年龄方面无显著差异,性别,BMI,糖尿病,高血压,石头尺寸,number,偏侧性,composition,和密度。平均手术时间,总能耗,术后停留时间,两组并发症相似。两组在术后1天随访时的SFR相似(p=0.091),而搬迁组3个月后取得了更高的SFR(97.8%对84.4%,p=0.026)。重新定位组的WisQol评分也明显高于原位组(126.98vs110.18,p<0.001)。
结论:在FURS手术期间通过重新定位技术获得了满意的SFR,并发症发生率相对较低。
OBJECTIVE: To compare the efficacy and safety of relocating the lower pole stones to a favorable pole during flexible ureteroscopy with in situ lithotripsy for the treatment of 10-20 mm lower pole stone (LPS).
METHODS: This study was a prospective analysis of patient outcomes who underwent an FURS procedure for the treatment of 10-20 mm lower pole renal stones from January 2020 to November 2022. The patients were randomized into a
relocation group or in situ group. The LPSs were relocated into a calyx, during lithotripsy in the
relocation group was performed, whereas the in situ group underwent FURS without
relocation. All the procedures were performed by the same surgeon. The patients\' demographic data, stone characteristics, perioperative parameters and outcomes, stone-free rate (SFR), complications, and overall costs were assessed retrospectively.
RESULTS: A total of 90 patients were enrolled and analyzed in this study (45 per group) with no significant differences between the two groups in terms of age, gender, BMI, diabetes, hypertension, stone size, number, laterality, composition, and density. The mean operation time, total energy consumption, postoperative stay, and complications were similar between the groups. Both groups had similar SFR at 1 day postoperative follow-up (p = 0.091), while the
relocation group achieved significantly higher SFR 3 months later (97.8% vs 84.4%, p = 0.026). The
relocation group also had a significantly higher WisQol score than the in situ group (126.98 vs 110.18, p < 0.001).
CONCLUSIONS: A satisfactory SFR with a relatively low complication rate was achieved by the relocation technique during the FURS procedure.