Efficacy and safety of holmium laser lithotripsy using different flexible ureteroscopes for medullary sponge kidney stones

doi:10.3877/cma.j.issn.1674-0785.2019.12.007

Abstract

Abstract:

Objective

To compare the efficacy and safety of holmium laser lithotripsy using integrated flexible and rigid ureteroscope and electron ureteroscope in the treatment of medullary sponge kidney stones.

Methods

Eighteen patients with medullary sponge kidney stones were treated by holmium laser lithotripsy using either electron flexible ureteroscope (10 cases, group A) or integrated flexible and rigid ureteroscope (8 cases, group B) from January 2015 to January 2018. The Fisher's exact probability method and independent samples t-test was used to compare the differences between the two groups in operation time, complication rate, successful rate of endoscopic insertion, successful rate of lithotripsy, postoperative hospital stay, and stone-free rate.

Results

Operation time was significantly different between the two groups ([62.6±8.8] min vs [72.8±7.5] min, t=2.513, P<0.05). Electron flexible ureteroscope had better visualization than integrated flexible and rigid ureteroscope. There were no significant differences between the two groups in complication rate, successful rate of endoscopic insertion, successful rate of lithotripsy, postoperative hospital stay, or stone-free rate (P>0.05).

Conclusion

Both integrated flexible and rigid ureteroscope and electron ureteroscope are safe and effective in the treatment of medullary sponge kidney stones.

Key words: Medullary sponge kidney, Kidney calculi, Sun′s ureteroscope, Flexible ureteroscope

Xuhui Zhang, Fan Liu, Qiqi Qin, Min Zhang, Bin Zhang, Xiaobin Yuan, Dongwen Wang. Efficacy and safety of holmium laser lithotripsy using different flexible ureteroscopes for medullary sponge kidney stones[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(12): 910-913.

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Figures/Tables 3

References 13

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组别	例数	性别（例）		年龄（岁，±s）	结石位置（例）		结石直径（mm，±s）	结石数目（个，±s）	CT值（HU，±s）	体质量指数（kg/m²，±s）
组别	例数	男	女	年龄（岁，±s）	肾盂及上中盏	下盏	结石直径（mm，±s）	结石数目（个，±s）	CT值（HU，±s）	体质量指数（kg/m²，±s）
电子输尿管软镜组	10	3	7	30.0±9.7	6	4	16.5±3.1	3.3±1.4	925±359	24.3±2.6
孙氏镜组	8	2	6	27.6±9.2	5	3	16.0±3. 3	2.93±1.1	876±426	23.5±2.4
统计值	?	-		t=0.527	-		t=0.333	t=0.439	t=0.263	t=0.625
P值	?	1.000		0.605	1.000		0.744	0.661	0.796	0.541

组别	例数	性别（例）		年龄（岁，±s）	结石位置（例）		结石直径（mm，±s）	结石数目（个，±s）	CT值（HU，±s）	体质量指数（kg/m²，±s）
组别	例数	男	女	年龄（岁，±s）	肾盂及上中盏	下盏	结石直径（mm，±s）	结石数目（个，±s）	CT值（HU，±s）	体质量指数（kg/m²，±s）
电子输尿管软镜组	10	3	7	30.0±9.7	6	4	16.5±3.1	3.3±1.4	925±359	24.3±2.6
孙氏镜组	8	2	6	27.6±9.2	5	3	16.0±3. 3	2.93±1.1	876±426	23.5±2.4
统计值	?	-		t=0.527	-		t=0.333	t=0.439	t=0.263	t=0.625
P值	?	1.000		0.605	1.000		0.744	0.661	0.796	0.541

组别	例数	手术时间［min，±s］	上镜成功率［例（%）］	碎石成功率［例（%）］	术后住院时间［d，±s］	术后3个月清石率［例（%）］	并发症［例（%）］
电子输尿管软镜组	10	72.8±7.5	10（100）	9（90.0）	3.3±1.0	8（77.8）	1（11.1）
孙氏镜组	8	62.6±8.8	8（100）	7（82.5）	3.2±1.1	6（71.4）	1（14.3）
统计值	?	t=2.513	-	-	t=0.090	-	-
P值	?	0.025	1.000	1.000	0.930	1.000	1.000

组别	例数	手术时间［min，±s］	上镜成功率［例（%）］	碎石成功率［例（%）］	术后住院时间［d，±s］	术后3个月清石率［例（%）］	并发症［例（%）］
电子输尿管软镜组	10	72.8±7.5	10（100）	9（90.0）	3.3±1.0	8（77.8）	1（11.1）
孙氏镜组	8	62.6±8.8	8（100）	7（82.5）	3.2±1.1	6（71.4）	1（14.3）
统计值	?	t=2.513	-	-	t=0.090	-	-
P值	?	0.025	1.000	1.000	0.930	1.000	1.000

组别	颜色分辨力和色还原性	术中视野清晰度	视野范围	视觉疲劳度	视野模糊次数
电子输尿管软镜组	5	5	5	5	0
孙氏镜组	4	3	2	3	2

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