在复杂的脏手术中,可重复使用的与一次性使用的尿管镜的成本:一个随机的队列研究
Rei Unno1, Kazumi Taguchi2, Shuzo Hamamoto1
1Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
World journal of urology
|November 10, 2025
概括
单次使用的尿道镜 (URS) 对于内镜联合内手术 (ECIRS) 更具成本效益,特别是在复杂的病例中. 可重复使用的URS显示出更高的成本和维修需求,尽管无石材的比率相似.
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
- 卫生经济学 卫生经济学
背景情况:
- 内镜联合内手术 (ECIRS) 使用尿管镜 (URS) 进行复杂的结石管理.
- 在可重复使用和一次性使用的URS之间做出选择会影响程序成本和资源利用.
- 评估最新一代数字可重复使用URS与一次性使用范围的成本效益对于优化ECIRS至关重要.
研究的目的:
- 进行成本效益分析,比较新的数字可重复使用尿道镜 (URF-V3) 与ECIRS中的一次性尿道镜.
- 评估与每种类型尿道镜相关的经济影响和外科结果.
主要方法:
- 在178名ECIRS患者 (2021年9月 - 2024年6月) 中,一项随机队列研究将URF-V3可重复使用范围与7.5Fr灵活的一次性使用范围进行了比较.
- 根据物理和石材特征,患者被随机分配.
- 主要终点是每次手术的成本和范围的耐用性;次要终点包括手术结果,如无石头率和手术时间.
主要成果:
- 与URF-V3 (1499美元) 相比,单次使用视野镜 (840美元) 的每病例成本要低得多.
- 在平均13.5个案例之后,URF-V3视野需要修复,亏平衡点在156个案例.
- 单次使用的视野与更高的激光能量使用,更频繁的URS辅助访问和更长的操作时间有关,但实现了类似的无石头率.
结论:
- 单次使用的柔性尿管望远镜在ECIRS中显示出经济优势,特别是在复杂的程序中.
- 在ECIRS中积极使用灵活的URS增加了范围损坏的风险,在某些情况下有利于单次使用的选项.
- 虽然可重复使用的探针具有更高的初始成本和维修频率,但它们的长期成本效益取决于耐用性和使用模式.
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