Direct-in-scope suction with a 5.1Fr large working channel ureteroscope: what stone dust size for effective evacuation during laser lithotripsy? An in vitro analysis by PEARLS and section of EAU Endourology.

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY
Ming Chun Chan, Vineet Gauhar, Soon Hock Koh, Frédéric Panthier, Eugenio Ventimiglia, Vincent De Coninck, Stefano Moretto, Aideen Madden, Anil Shrestha, Sung Yung Cho, Esteban Emiliani, Steffi Kar Kei Yuen, Thomas R W Herrmann, Bhaskar Somani, Olivier Traxer, Etienne Xavier Keller, Jia-Lun Kwok
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引用次数: 0

Abstract

Purpose: A novel larger 5.1Fr working channel flexible ureteroscope for Direct-In-Scope Suction (DISS) has recently been introduced. However, the optimal stone dust size for successful evacuation without working channel blockage is currently unknown.

Methods: In vitro assessment of the PU400A 9.2Fr ureteroscope (Zhuhai Pusen Medical Technology Co., Ltd, China) was performed with BegoStone particle sizes ≤ 2000 μm (size range 1000-2000 μm), ≤ 1000 μm (500-1000 μm), ≤ 500 μm (250-500 μm), ≤ 250 μm (125-250 μm) and ≤ 125 μm (63-125 μm), in a kidney calyx model. This was conducted with an empty working channel, and with occupancy by 150 μm Olympus, 200 μm Quanta, 270 μm Dornier laser fibers. Primary outcome was complete suction-evacuation without working channel blockage. Secondary outcome was evacuation speed for particle sizes that did not have blockage.

Results: A stone particle size upper limit of 250 μm was found to achieve complete suction-evacuation without blockage, across all working channel occupancy situations. For stone particle size of range 125-250 μm, evacuation speeds were 35, 26, 13, 11 mm3/s across empty, 150 μm Olympus, 200 μm Quanta, 270 μm Dornier laser fiber occupancy, respectively (ANOVA = p < 0.001). For stone particle size range 63-125 μm, evacuation speeds were 19, 14, 9, 8 mm3/s respectively (ANOVA = p < 0.001).

Conclusion: The 5.1Fr working channel DISS ureteroscope allows a stone particle size limit of 250 μm to be suction-evacuated without blockage, even with laser fiber occupancy. With a laser fiber, a smaller 150 μm fiber size allows better particle evacuation speeds. Urologists should therefore aim for a dust particle size of ≤ 250 μm in routine DISS with the 5.1Fr working channel ureteroscope, for effective intraoperative stone evacuation.

5.1Fr大工作通道输尿管镜直接吸痰:激光碎石术中,什么尺寸的石尘可以有效排出?体外珍珠造影及泌尿系统造影切片分析。
目的:最近介绍了一种用于直接镜内吸引(DISS)的新型更大的5.1Fr工作通道柔性输尿管镜。然而,在没有工作通道堵塞的情况下成功疏散的最佳石粉尺寸目前尚不清楚。方法:采用BegoStone粒径≤2000 μm(粒径范围1000 ~ 2000 μm)、≤1000 μm (500 ~ 1000 μm)、≤500 μm (250 ~ 500 μm)、≤250 μm (125 ~ 250 μm)、≤125 μm (63 ~ 125 μm)的肾花筒模型对PU400A 9.2Fr输尿管镜(珠海普森医疗科技有限公司)进行体外评价。这是在一个空的工作通道中进行的,并且占用了150 μm奥林巴斯,200 μm量子,270 μm多尼尔激光光纤。主要结局是完全吸出,无工作通道堵塞。次要结果是没有堵塞的颗粒尺寸的疏散速度。结果:在所有工作通道占用情况下,石头粒径上限为250 μm可以实现完全吸排而不堵塞。对于粒径范围为125 ~ 250 μm的结石,空腔、150 μm Olympus、200 μm Quanta、270 μm Dornier激光光纤的吸出速度分别为35、26、13、11 mm3/s (ANOVA = 3/s)。结论:5.1Fr工作通道DISS输尿管镜在激光光纤占据的情况下,可对粒径限制在250 μm以内的结石进行吸出而不堵塞。对于激光光纤,150 μm的光纤尺寸越小,粒子的疏散速度越快。因此,泌尿科医生在5.1Fr工作通道输尿管镜下进行常规DISS时,应将粉尘粒径≤250 μm作为目标,以实现术中有效的结石排出。
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来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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