尿道透视期间的不确定性:评估激光石后在体内石灰尘的外科医生共识
Levi Bowers1, Kimberly Maciolek1, Ryan S Hsi1
1Department of Urology, VUMC, Nashville, TN.
Urology
|September 27, 2025
概括
外科医生很难就石灰质量达成一致,并且仅基于视觉线索,在尿路透镜检查 (URS) 后精确预测无石头状态. 需要客观的工具才能在治疗结石方面取得更好的结果.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 内分泌学是什么?内分泌学是什么
- 手术技术 手术技术
背景情况:
- 尿道透视术 (URS) 带有激光光是治疗结石的常见手术.
- 评估石灰尘的质量和预测无石头状态可以指导治疗.
- 目前的方法依赖于外科医生的视觉评估,这可能缺乏标准化.
研究的目的:
- 评估外科医生在URS期间对石灰质量的共识.
- 评估基于手术内内镜外观预测无石头状态的准确性.
- 为了比较教师和学员在这些评估中的表现.
主要方法:
- 16个尿道镜激光光视频被15名泌尿科医生 (教师和实习生) 审查.
- 审稿人评价了石灰尘的质量,并预测了无石头的状态.
- 分析了评估者之间的可靠性 (ICC) 和预测准确性.
主要成果:
- 关于尘埃质量的不良评级者间协议 (ICC=0.41).
- 平均无石头预测准确率为63%,教师和学员之间没有显著差异.
- 预测残留碎片的灵敏度为55%,特异性为72%,有些病例导致显著的临床事件.
结论:
- 外科医生对石灰质量的评估是不一致的.
- 基于内镜外观的无石头状态的预测准确性有限.
- 为了优化激光石手术结果,需要标准化的定义和客观的手术内工具.
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