尿道接入的使用是否能改善尿道透视术中术后的结果? 一个现实世界的多机构研究
Abdel Bakayoko1,2, Céline Mardelli2, Hugo Dupuis3
1Department of Urology, University of Caen, Caen, France.
Urolithiasis
|September 29, 2025
概括
在结石逆行性内手术 (RIRS) 期间使用尿道接入 (UAS) 并没有改善无结石率. 然而,UAS与更长的手术和增加的发病率有关,这表明常规使用可能不必要.
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
背景情况:
- 逆行性内手术 (RIRS) 是对结石的关键治疗方法.
- 在RIRS期间经常使用尿道接入 (UAS),以方便仪器通道和灌.
- 在RIRS中常规UAS使用的必要性和影响仍在争论中.
研究的目的:
- 评估尿管接入 (UAS) 使用对结石逆行性内手术 (RIRS) 患者的结局的影响.
- 为了比较RIRS与无人机系统和无人机系统之间的无石石率,操作时间,并发症率和手术类型.
主要方法:
- 对1177名接受结石RIRS治疗的患者进行了回顾性多中心队列研究 (2017年1月 - 2018年12月).
- 患者根据UAS使用情况进行了分层.
- 应用治疗权重的逆概率 (IPTW) 来调整群体之间的基线差异.
主要成果:
- 三个月后的无石头率在各组之间是可比的 (p=0.12).
- 无人机使用与更长的手术时间 (p=0.04) 和更高的术后支架 (p<0.001) 的可能性有关.
- 两组之间总体或重大并发症发生率没有显著差异.
结论:
- 在结石RIRS中使用尿道接入与类似的无结石率有关,但增加了外科手术期间的发病率.
- 在所有RIRS程序中,常规UAS使用可能不是必不可少的.
- 需要进行更多的随机对照试验,以确定UAS在RIRS中的作用.
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