Volume 21 Issue 9
Sep.  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(9): 1516-1519
WU Xiaojiang, TIAN Wenjun, ZHENG Dawen, ZHENG Feng. Study on the treatment of upper urinary tract stones 2-3 cm in diameter using a flexible negative pressure suction sheath combined with flexible ureterorenoscopy holmium lithotripsy[J]. Chinese Journal of General Practice, 2023, 21(9): 1516-1519. doi: 10.16766/j.cnki.issn.1674-4152.003159
Citation: WU Xiaojiang, TIAN Wenjun, ZHENG Dawen, ZHENG Feng. Study on the treatment of upper urinary tract stones 2-3 cm in diameter using a flexible negative pressure suction sheath combined with flexible ureterorenoscopy holmium lithotripsy[J]. Chinese Journal of General Practice, 2023, 21(9): 1516-1519. doi: 10.16766/j.cnki.issn.1674-4152.003159
shu

Study on the treatment of upper urinary tract stones 2-3 cm in diameter using a flexible negative pressure suction sheath combined with flexible ureterorenoscopy holmium lithotripsy

doi: 10.16766/j.cnki.issn.1674-4152.003159

  • Department of Urology, Pujiang County People' s Hospital, Jinhua, Zhejiang 322200, China

Funds:

 2023XY070

  • Received Date: 2023-04-28
    Available Online: 2023-10-19
    Abstract
  •   Objective  To observe the clinical efficacy and safety of flexible negative pressure ureteral access sheath combined with flexible ureterorenoscopy holmium lithotripsy (FURL) for upper urinary tract calculi.  Methods  A total of 168 patients with upper urinary tract calculi (2 to 3 cm in diameter), who admitted to Pujiang People' s Hospital from March 2019 to September 2022, were selected as the research objects. They were divided into study group (84 cases) and control group (84 cases) by random number table method. The study group was treated with flexible negative pressure suction sheath combined with FURL, and the control group was treated with percutaneous holmium laser nephrolithotomy (PCNL). The operation duration, urine clearance time, first time out of bed, hospital stay and other surgical indicators were recorded, and the stone clearance rate was calculated, the levels of serum inflammatory factor, stress response factors and renal function index content were determined before and after operation, and the postoperative complications were observed.  Results  The study group had significantly shorter operative duration, urine clearance time, first time out of bed, and hospitalization time [(64.75±5.62) min, (2.53±0.36) d, (1.81±0.32) d, (7.25±0.86) d] compared to the control group [(73.84±5.93) min, (3.29±0.41) d, (2.47±0.39) d, (9.48±1.07) d, all P < 0.05]. There was no significant difference in stone clearance rate between the two groups [94.05% (79/84) vs. 97.62% (82/84), P > 0.05]. The levels of inflammatory factors [tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), IL-6 and IL-8], stress response factors [norepinephrine (NE), cortisol (Cor)] and renal function indicators [serum creatinine (SCr), blood urea nitrogen (BUN), uric acid (UA) and cystatin C (Cys-C)] were significantly lower than the control group 3 days after operation (all P < 0.05). The overall incidence of postoperative complications was significantly lower in the study group than that in the control group (P < 0.05).  Conclusion  The flexible negative pressure suction sheath combined with FURL can be used to treat upper urinary tract calculi with a diameter of 2-3 cm. On the basis of ensuring the effectiveness of stone removal, it can shorten the operation time, promote the rapid recovery of patients after operation, reduce iatrogenic trauma, reduce the degree of inflammation and stress reaction of patients, reduce postoperative complications.

     

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