国产一次性电子输尿管软镜联合负压吸引鞘治疗单侧重复肾重复输尿管畸形合并上尿路结石的疗效分析

Efficacy of domestic disposable electronic flexible ureteroscope combined with negative-pressure suction sheath in treatment of unilateral duplicate renal and duplicate ureteral malformations with upper urinary tract calculi

目的:探讨国产一次性电子输尿管软镜联合负压吸引鞘治疗单侧重复肾重复输尿管畸形合并上尿路结石的有效性及安全性。方法:回顾性分析2018年5月至2023年9月武汉大学人民医院泌尿外科收治的17例单侧重复肾重复输尿管畸形合并上尿路结石的患者资料,该17例患者均采用输尿管软镜联合负压吸引鞘治疗上尿路结石。分析其结石分布、结石大小、手术时间、术中术后并发症、术后住院时间、结石清除率等,并随访患者的术后情况。结果:所有17例患者手术顺利,手术时间27~65 min,平均(43.4±6.7)min,术中术后均未出现输尿管撕裂、穿孔、感染性休克等严重并发症。术后1~3个月复查腹部平片(kidney ureter bladder,KUB)或泌尿系计算机断层扫描(computed tomography,CT),15例患者结石清除,结石清除率15/17(88.24%)。二期手术患者2例,二期手术结石清除率100%。结论:国产一次性电子输尿管软镜联合负压吸引鞘治疗单侧重复肾重复输尿管畸形合并上尿路结石,结石清除率高,手术并发症少,具有良好的有效性及安全性。

Objective:To investigate the efficacy and safety of domestic disposable electronic flexible ureteroscope combined with negative-pressure suction sheath in the treatment of unilateral duplicate renal and duplicate ureteral malformations with upper urinary tract calculi.Methods:A retrospective analysis was performed for the data of 17 patients with unilateral duplicate renal and duplicate ureteral malformations,and upper urinary tract calculi who were admitted to Renmin Hospital of Wuhan University from May 2018 to September 2023,and all 17 patients were treated with flexible ureteroscope combined with negative-pressure suction sheath for upper urinary tract calculi.The patients were analyzed in terms of the distribution of calculi,the size of calculi,time of operation,intraopera⁃tive and postoperative complications,length of postoperative hospital stay,and stone clearance,and they were followed up to observe postoperative conditions.Results:All 17 patients underwent the surgery smoothly,with a time of operation of 27-65 minutes(mean 43.4±6.7 minutes),and there were no serious complications,such as ureteral tear,perforation,and septic shock,during or after the surgery.At 1-3 months after surgery,kidney-ureter-bladder abdominal radiography or urinary tract computed tomography showed stone clearance in 15 patients,with a stone clearance rate of 88.24%(15/17).Two patients underwent second-stage surgery,with a stone clearance rate of 100%.Conclusion:Domestic disposable electronic flexible ureteroscope combined with negative-pressure suc⁃tion sheath has good efficacy and safety in the treatment of unilateral duplicate renal and duplicate ureteral malformations with upper urinary tract calculi,with a high stone clearance rate and few surgi⁃cal complications.