研究由CT值 (HU) 评估的结石密度对上尿路结石完全碎裂所用的总激光能量 (TLE) 和总激光时间 (TLT) 的影响。此外,我们还研究了结石成分对碎裂所需的激光能量和时间的影响。本研究纳入了 30 名符合纳入和排除标准的连续患者。包括大小为 5-20 mm 的肾或近端输尿管结石患者。使用 Ho:YAG 100 W 激光进行结石碎裂,TLT 和 TLE 与 HU 和结石成分相关。 结果:平均结石直径为 10.83 ± 3.5 mm,平均 HU 为 893 ± 315。平均 TLE 和 TLT 分别为 8.86 ± 3.12 kJ 和 18.46 ± 6.9 min。我们观察到 HU 和 TLE 之间(r = 0.84,p 值 < 0.001)以及 HU 和 TLT 之间(r = 0.58,p 值 = 0.001)之间存在很强的正相关。然而,石材成分不影响激光能量(p 值 = 0.36)和激光时间(p 值 = 0.30)。结石直径也与 TLE (r = 0.41; p = 0.02) 和 TLT (r = 0.54; p- 0.002) 呈显着正相关。当控制结石大小时,HU 与 TLE(r = 0.83;p < 0.001)和 TLT(r = 0.52;p = 0.004)的相关性仍然显着。结论:当使用 Ho:YAG 激光破碎结石时,HU 和结石直径是 TLE 和 TLT 的重要预测因子。然而,结石成分和位置未能对这些参数中的任何一个显示出任何显着影响。
参考文献
Mutter mit blauen Flecken: Warnsignal fürs Kindeswohl! : Häusliche Gewalt.Starostzik C.MMW Fortschr Med. 2020 Oct;162(17):20-21. doi: 10.1007/s15006-020-4403-y.PMID: 33020856 German. No abstract available. Cost comparison of single-use versus reusable flexible ureteroscope: A systematic review.Ventimiglia E, Godínez AJ, Traxer O, Somani BK.Turk J Urol. 2020 Nov;46(Supp. 1):S40-S45. doi: 10.5152/tud.2020.20223. Epub 2020 Aug 25.PMID: 32877637 Free PMC article. Review. Flexible ureteroscopy lithotripsy combined with metallic ureteral stents for the treatment of patients with upper urinary tract calculi.Li T, Sun X, Li X, He Y.Exp Ther Med. 2020 Oct;20(4):3330-3335. doi: 10.3892/etm.2020.9038. Epub 2020 Jul 24.PMID: 32855705 Free PMC article. A novel robotic system for flexible ureteroscopy.Shu X, Chen Q, Xie L.Int J Med Robot. 2021 Feb;17(1):1-11. doi: 10.1002/rcs.2191. Epub 2020 Nov 13.PMID: 33103335 Is a ureteral stent required before flexible ureteroscopy?Hu Q, Ji Y, Wang Z, Lai Y, Deng Q, Zhang J, Wang H, Liang H, Zhao H.Transl Androl Urol. 2020 Dec;9(6):2723-2729. doi: 10.21037/tau-20-1458.PMID: 33457244 Free PMC article. The role of phagocytic leukocytes following flexible ureterenoscopy, for the treatment of kidney stones: an observational, clinical pilots-study.Hughes SF, Moyes AJ, Lamb RM, Ella-Tongwiis P, Snyper NYF, Shergill I.Eur J Med Res. 2020 Dec 11;25(1):68. doi: 10.1186/s40001-020-00466-7.PMID: 33308282 Free PMC article.Comparison of single-use and reusable flexible ureteroscope for renal stone management: a pooled analysis of 772 patients.Li Y, Chen J, Zhu Z, Zeng H, Zeng F, Chen Z, Yang Z, Cui Y, Chen H, Li Y.Transl Androl Urol. 2021 Jan;10(1):483-493. doi: 10.21037/tau-20-1009.PMID: 33532336 Free PMC article. Review. Small Ureteral Access Sheath in Treating Paediatric Urolithiasis: A Single Centre Experience.Aljumaiah S, Allubly N, Alshammari A, Alkhamees M, Hamri SB.Res Rep Urol. 2020 Dec 22;12:663-668. doi: 10.2147/RRU.S277855. eCollection 2020.PMID: 33376709 Free PMC article.Minimally Invasive Surgeries in The Management of Renal Parapelvic Cysts: A Retrospective Comparative Study.Chen H, Chen G, Pan Y, Jin X.Urol J. 2021 Jan 26. doi: 10.22037/uj.v16i7.6466. Online ahead of print.PMID: 33495985 Free article. 21 Single-use digital flexible ureteroscopes as a safe and effective choice for the treatment of lower pole renal stones: secondary analysis of a randomized controlled trial.Yang E, Jing S, Niu Y, Qi S, Prabin KY, Yang L, Bao J, Tian J, Wang J, Li N, Ou T, Wang Z.J Endourol. 2021 Aug 10. doi: 10.1089/end.2021.0170. Online ahead of print.PMID: 3437512722.Development and internal validation of a nomogram to predict perioperative complications after flexible ureteroscopy for renal stones in overnight ureteral catheterization cases.Komeya M, Odaka H, Asano J, Asai T, Saigusa Y, Ogawa T, Yao M, Matsuzaki J.World J Urol. 2020 Sep;38(9):2307-2312. doi: 10.1007/s00345-019-03023-y. Epub 2019 Nov 29.PMID: 31784774 23 A novel ureteroscopy training platform which utilizes CT urograms to replicate complex renal collecting system anatomies.Seo N, Alsaikhan B, Gao B, Djuimo M, Koo S, Hosseinpour S, Carrillo B, Farcas M.J Endourol. 2021 Jul 17. doi: 10.1089/end.2021.0163. Online ahead of print.PMID: 34278810 24.[Flexible ureteroscopy for lower pole renal stones: novel superpulse thulium (TM) fiber laser lithotripsy].Rapoport LM, Gazimiev MA, Korolev DO, Tsarichenko DG, Svetikova YUA, Enikeev ME, Akopyan GN, Chinenov DV, Taratkin MS, Enikeev DV.Urologiia. 2020 Dec;(6):89-92.PMID: 33427418 Russian. 25Percutaneous Nephrolithotomy Can Reduce the Incidence of Sepsis Compared with Flexible Ureteroscopy in Treating Solitary Proximal Ureteral Stone Patients with Positive Urine Culture.Xia QD, Wang YF, Liu CQ, Xu JZ, Sun JX, Xun Y, Li C, Hu J, Lu JL, Wang SG.Biomed Res Int. 2021 Apr 12;2021:9927498. doi: 10.1155/2021/9927498. eCollection 2021.PMID: 33954204 Free PMC article. 26 Gap between UAS and ureteroscope predicts renal stone-free rate after flexible ureteroscopy with the fragmentation technique.Komeya M, Odaka H, Watanabe T, Kiuchi H, Ogawa T, Yao M, Matsuzaki J.World J Urol. 2021 Jul;39(7):2733-2739. doi: 10.1007/s00345-020-03459-7. Epub 2020 Sep 25.PMID: 32986134 27.Influence of Body Mass Index on the Surgical Outcomes of Flexible Ureteroscopy for Pediatric Upper Urinary Tract Aalculi-A Single Surgeon Experience.Zhang Y, Wang X, Li J, Yian Y.Urology. 2021 Jul;153:291-297. doi: 10.1016/j.urology.2020.11.013. Epub 2020 Nov 20.PMID: 33227303 28 Flexible ureterorenoscopy and laser lithotripsy with regional anesthesia vs general anesthesia: A prospective randomized study.Sahan M, Sarilar O, Akbulut MF, Demir E, Savun M, Sen O, Ozgor F.Int Braz J Urol. 2020 Nov-Dec;46(6):1010-1018. doi: 10.1590/S1677-5538.IBJU.2019.0770.PMID: 32822130 Free PMC article. Clinical Trial.29 Actual Management of Anterior Calyceal Diverticular Calculi: A Challenging Flexible Retrograde Endoscopic Approach.Barki A, El Moudane A.Case Rep Urol. 2020 Sep 16;2020:7983242. doi: 10.1155/2020/7983242. eCollection 2020.PMID: 33014508 Free PMC article.30Systematic Review and Meta-Analysis Comparing Fluoroless Ureteroscopy and Conventional Ureteroscopy in the Management of Ureteral and Renal Stones.Subiela JD, Kanashiro A, Emiliani E, Villegas S, Sánchez-Martín FM, Millán F, Palou J, Angerri O.J Endourol. 2021 Apr;35(4):417-428. doi: 10.1089/end.2020.0915. Epub 2020 Nov 16.PMID: 33076706Evaluation of flexible ureteroscope with an omni-directional bending tip, using a JOYSTICK unit (URF-Y0016): an ex-vivo study.Inoue T, Okada S, Hamamoto S, Miura H, Matsuzaki J, Tambo M, Fukuhara H, Fujisawa M, Matsuda T, Nutahara K.World J Urol. 2021 Jan;39(1):209-215. doi: 10.1007/s00345-020-03151-w. Epub 2020 Mar 14.PMID: 32172330 Ergonomics and Surgeon Comfort During Flexible Ureteroscopy.Alnadhari I, Ali O, Abdeljaleel O, Sampige VRP, Shamsodini A, Salah M.Res Rep Urol. 2021 Jun 28;13:415-424. doi: 10.2147/RRU.S317347. eCollection 2021.PMID: 34235098 Free PMC Predictors of Repeat Surgery and Stone-related Events After Flexible Ureteroscopy for Renal Stones.Ito K, Takahashi T, Somiya S, Kanno T, Higashi Y, Yamada H.Urology. 2021 Aug;154:96-102. doi: 10.1016/j.urology.2021.02.025. Epub 2021 Mar 3.PMID: 33667526 Evaluation of the Impact of Ureteroscope, Access Sheath, and Irrigation System Selection on Intrarenal Pressures in a Porcine Kidney Model.MacCraith E, Yap LC, Elamin M, Patterson K, Brady CM, Hennessey DB.J Endourol. 2021 Apr;35(4):512-517. doi: 10.1089/end.2020.0838. Epub 2020 Nov 5.PMID: 32967460 Flexible ureteroscopy versus miniaturized percutaneous nephrolithotomy for renal stones of 1-2 cm.Ather MH, Sulaiman MN.Fac Rev. 2020 Dec 22;9:29. doi: 10.12703/r/9-29. eCollection 2020.PMID: 33659961 Free PMC article. Review.Comparison of intrapelvic pressures during flexible ureteroscopy, mini-percutaneous nephrolithotomy, standard percutaneous nephrolithotomy, and endoscopic combined intrarenal surgery in a kidney model.Doizi S, Uzan A, Keller EX, De Coninck V, Kamkoum H, Barghouthy Y, Ventimiglia E, Traxer O.World J Urol. 2021 Jul;39(7):2709-2717. doi: 10.1007/s00345-020-03450-2. Epub 2020 Sep 21.PMID: 32955661A cut-off value for the operation time and other risk factors in terms of the infection risk for flexible ureterorenoscopy.Günseren KÖ, Demir A, Celen S, Çiçek MÇ, Kılıçarslan H.Int J Clin Pract. 2021 Apr;75(4):e13846. doi: 10.1111/ijcp.13846. Epub 2020 Dec 1.PMID: 33222355Preoperative urine nitrite versus urine culture for predicting postoperative fever following flexible ureteroscopic lithotripsy: a propensity score matching analysis.Ma YC, Jian ZY, Li H, Wang KJ.World J Urol. 2021 Mar;39(3):897-905. doi: 10.1007/s00345-020-03240-w. Epub 2020 May 19.PMID: 32430571In-vitro and in-vivo new evidence for Flexor® Vue™ deflecting endoscopic system use: optimization of the stone free rate (SFR) after flexible ureteroscopy and Ho:YAG laser lithotripsy.Saita A, Villa L, Persico F, Lughezzani G, Prezioso D, Casale P.Urolithiasis. 2021 Jun;49(3):239-245. doi: 10.1007/s00240-020-01215-5. Epub 2020 Oct 1.PMID: 33005998Hounsfield units-a significant predictor of lasering time and energy in the management of upper urinary tract stones using Holmium: Yttrium-Aluminum Garnet lasers.Rana RS, Ather MH.Int Urol Nephrol. 2020 Sep;52(9):1637-1641. doi: 10.1007/s11255-020-02442-w. Epub 2020 Apr 6.PMID: 32253619