Dusting versus fragmentation for large proximal ureteral stones during flexible ureteroscopy: A prospective randomized study.

IF 1.3 4区 医学 Q4 UROLOGY & NEPHROLOGY
Current Urology Pub Date : 2025-07-01 Epub Date: 2025-05-19 DOI:10.1097/CU9.0000000000000285
Samer Morsy, Ahmed Essam, Islam Nasser, Mohamed Elsheikh, Sherif Abdel Rahman, Kareem Daw
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引用次数: 0

Abstract

Background: Recent advances in endoscopic technology have empowered urologists to treat most types of stones within the urinary tract effectively. Available treatments for ureteral stones using a laser lithotripter include fragmentation, the active removal of fragments with a basket, and dusting. To date, only a few prospective randomized studies have endorsed the use of stone dusting, fragmentation, and active removal for ureteric stones.

Materials and methods: This randomized, prospective, comparative study was conducted in the Urology Department. Sixty patients with proximal ureteral stones from July 2019 to July 2020 were included and randomly divided into 2 groups using a random number generator program (version 2, 2015). In Group 1, the stones were fragmented into dust (n = 30), and in Group 2, lithotripsy produced extractable fragments (n = 30).

Results: In this study, the Ho:YAG laser was used to dust stones at low energy and high frequency (0.4-0.6 J and 20-30 Hz). Using the Ho:YAG laser set to high energy and low frequency (1.5-2 J and 8-10 Hz), stone fragmentation was achieved. The mean stone size was 1.63 cm in Group 1 and 1.69 cm in Group 2. The stone-free rates for the dusting and fragmentation groups were 96.6% and 86.6%, respectively. Meanwhile, the mean operative time was 87.6 ± 33.6 minutes in the dusting group and 80.4 ± 28.8 minutes in the fragmentation group. There were no postoperative complications with the dusting technique, compared with a 13.3% complication rate with the fragmentation technique.

Conclusions: For proximal ureteral stones, the stone-free rates between the dusting and fragmentation procedures were comparable. Both techniques proved to be effective.

Abstract Image

输尿管软性镜检查中输尿管近端结石的碎石治疗:一项前瞻性随机研究。
背景:最近内镜技术的进步使泌尿科医生能够有效地治疗尿路内大多数类型的结石。使用激光碎石机治疗输尿管结石的现有方法包括碎石、用篮子主动清除碎片和除尘。迄今为止,只有少数前瞻性随机研究支持使用结石粉、碎片化和主动清除输尿管结石。材料和方法:这项随机、前瞻性、比较研究在泌尿外科进行。选取2019年7月至2020年7月60例输尿管近端结石患者,采用随机数生成器程序(2015年2版)随机分为2组。在第1组,石头被粉碎成灰尘(n = 30),在第2组,碎石术产生可提取的碎片(n = 30)。结果:本研究采用Ho:YAG激光在低能量、高频率(0.4 ~ 0.6 J, 20 ~ 30 Hz)下对石材进行除尘。利用Ho:YAG激光设置为高能低频(1.5-2 J, 8-10 Hz),实现了石料破碎。1组平均结石大小为1.63 cm, 2组平均结石大小为1.69 cm。粉尘组和破碎组的无石率分别为96.6%和86.6%。同时,除尘组的平均手术时间为87.6±33.6分钟,碎裂组的平均手术时间为80.4±28.8分钟。与碎片化技术的13.3%的并发症率相比,粉碎技术无术后并发症。结论:对于输尿管近端结石,碎石术和碎石术之间的无结石率是相当的。这两种方法都被证明是有效的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Urology
Current Urology Medicine-Urology
CiteScore
2.30
自引率
0.00%
发文量
96
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