Zhang Meng,Chen Zhihong,Zhang Hongmei,et al.Comparison of F 4.8 visual nephroscope versus traditional rigid ureteroscope for ureteral stones in infants and children aged ≤36 months[J].Journal of Clinical Pediatric Surgery,,():647-651.[doi:10.3760/cma.j.cn101785-202410031-009]
Comparison of F 4.8 visual nephroscope versus traditional rigid ureteroscope for ureteral stones in infants and children aged ≤36 months
- Keywords:
- Infants; Ureteral Calculi; Ureteroscopy; Holmium Laser; Surgical Procedures; Operative
- Abstract:
- Objective To evaluate the safety and efficacy of F 4.8 visual nephroscope with holmium laser versus traditional ureteroscope plus holmium laser for ureteral stones in infants and young children. Methods A retrospective analysis was conducted for 33 infants and young children (aged ≤36 months) operated for ureteral stones between June 2021 and June 2024.Based upon surgical approaches,they were assigned into two groups of experimental (F 4.8 visual nephroscope,n=18) and control group (traditional ureteroscope,n=15).Experimental group underwent a single-stage procedure for stone fragmentation whereas control group had a two-stage approach with double-J stenting initially followed by a second-stage operation.The primary outcome measures included operative duration,postoperative hospitalization stay,hospitalization expense,incidence of postoperative complications and single-stage stone-free rate. Results All procedures were successfully completed without severe complications.As compared to traditional ureteroscope group,F 4.8 visual nephroscope group demonstrated significantly shorter operative duration[(25.5±4.8) vs. (34.8±3.7) min],shorter hospitalization stay[(2.9±0.3) vs. (4.3±0.6) days]and lower hospitalization expense[(1.58±0.11) vs. (1.73±0.09) ten thousamd].All differences were statistically significant (P<0.05).There were no statistically significant differences in the incidence of postoperative complications (P=0.481),primary stone-free rate (P=0.465),or stone composition (P=0.308) between the two groups. Multivariate Logistic regression analysis identified stone composition as an independent factor influencing both single-stage stone-free rate (OR=0.207,95%CI:0.185-0.231,P<0.001) and postoperative complication rate (OR=1.992,95%CI:1.782-2.227,P<0.001). Conclusions The combination of the F 4.8 visual nephroscope and holmium laser demonstrates higher stone-free rates and enhanced safety in the treatment of ureteral stones in infants,as reflected by significantly shorter operative times,reduced hospital stays and medical expenses,and improved postoperative recovery. Stone composition has been identified as an independent factor influencing both the primary stone-free rate and the incidence of postoperative complications.
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Memo
收稿日期:2024-10-14。
基金项目:山东省医药卫生科技项目(202306021028)
通讯作者:陈志鸿,Email:zhm-13@163.com