摘要
Abstract
Objective To evaluate the efficacy and safety of single-use flexible ureteroscopy(FURS)combined with a distal articulated suction sheath(ASS)in the treatment of impacted ureteral stones in a single-center retrospective cohort.Methods A total of 62 patients with unilateral impacted calculi from December 2023 to December 2024 were enrolled."Impaction"was defined as stone incarceration≥2 months with focal ureteral-wall thickening≥2 mm.All patients underwent holmium laser lithotripsy via FURS with ASS.The primary outcome was stone-free rate(SFR)on post-operative day 1;secondary outcomes included operative time,periopera-tive complications(Clavien-Dindo classification),length of stay and 3-6 month follow-up results.One-sample t-test and χ2 test were used to compare the data with pooled means from five analogous studies(n=666).Results All 62 cases achieved primary successful sheath placement(success rate 100%).Mean stone diameter was(15.4±4.2)mm and mean CT attenuation(1215±285)HU.SFR on day 1 was 95.2%,peri-operative complications were all Clavien grade Ⅰ-Ⅱ,mean post-operative stay was(2.6±0.9)days.Dur-ing the 3-6 month follow-up,the SFR was 100%and no ureteral stricture or severe hydronephrosis occurred.Compared with the pooled literature values,the operative time was shortened[(58.6±12.8)min vs.(66.0±14.5)min,t=6.13,P=0.002],the SFR increased(95.2%vs.88.5%,χ2=6.58,P=0.010),the complication rate was reduced(4.8%vs.9.4%,χ2=4.31,P=0.038),and all differences were statistically significant.Conclusions Single-use FURS combined with ASS in the treatment of impacted ureter-al calculi offers significantly superior outcomes in literature comparisons and be used as the first-line minimally invasive treatment for impacted ureteral stones.However,further multi-center randomized controlled trials are needed to validate the long-term efficacy.关键词
输尿管结石/嵌顿/输尿管软镜/可弯曲负压吸引鞘/钬激光Key words
ureteral calculus/impaction/flexible ureteroscopy/articulated suction sheath/holmium laser分类
医药卫生
