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尺寸问题:对柔性真空辅助尿道接入的体外评估

Aideen Madden^1,2,3, Carlos Altez⁴, Jordi Peña Lueza⁵

¹GRC N°20, Groupe de Recherche Clinique Sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.

|May 17, 2025

概括

这项研究发现,灵活的真空辅助尿道接入和一次性使用的数字灵活尿道镜的特定组合可以优化逆行内脏手术 (RIRS) 中的石块片段清除. 最佳的技术选择取决于碎片大小,以提高无石头率.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
最少侵入性的手术
腎石病的管理方法

背景情况:

逆行性肠内手术 (RIRS) 正在随着灵活真空辅助尿道接入 (FV-UAS) 和一次性数字灵活尿道镜 (SU-DFU) 的创新而发展.
优化吸收和碎片检索对于提高RIRS程序中无石头率至关重要.

研究的目的:

评估各种FV-UAS和SU-DFU组合在RIRS期间清除石块碎片的有效性.
为了确定内镜与外直径 (RESD) 的比率和吸收技术对石头清除的影响.

主要方法:

在六个RESD中测试了三个FV-UAS模型 (Clear PetraTM,YiGaoTM,InnovexTM) 和三个SU-DFU (HugemedTM,PusenTM,LithovueTM).
评估了两个吸入技术:连续的范围内的吸入和吸入的抽出.
在五个尺寸范围 (63微米至2毫米) 中评估了碎片清除.

主要成果:

0.53的RESD证明了广泛的有效性,在任何一种技术中都成功吸收了高达2毫米的碎片.
使用7.5Fr PusenTM尿管镜和12-14F FV-UAS (RESD 0.63) 实现了最大的石头清除率 (10.2 g/min),使用125-250μm碎片的持续在镜片吸收.
对于较小的碎片,连续的视野内吸收效果优越,而对于较大的碎片,吸收的拉出效果相当或更好.

结论:

RESD是一个重要的因素,但不是唯一决定RIRS无石率的决定因素.
技术的选择 (连续吸入与吸入拉出) 应根据预计的石块碎片大小进行调整.
尿道镜和接入的特定组合,以及适当的技术,可以显著改善石块片段的清除.

关键词:

愿望的愿望愿望的愿望灵活的真空辅助尿道接入外套剩余的时间剩余的时间吸收吸收吸收吸收

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