一次性输尿管软镜联合末端可弯曲负压吸引鞘治疗输尿管嵌顿性结石的疗效与安全性OA

Objective To evaluate the efficacy and safety of single-use flexible ureteroscopy(FURS)combined with a distal articulated suction sheath(ASS)in the treatment of impacted ureteral stones in a single-center retrospective cohort.Methods A total of 62 patients with unilateral impacted calculi from December 2023 to December 2024 were enrolled."Impaction"was defined as stone incarceration≥2 months with focal ureteral-wall thickening≥2 mm.All patients underwent holmium laser lithotripsy via FURS with ASS.The primary outcome was stone-free rate(SFR)on post-operative day 1;secondary outcomes included operative time,periopera-tive complications(Clavien-Dindo classification),length of stay and 3-6 month follow-up results.One-sample t-test and χ2 test were used to compare the data with pooled means from five analogous studies(n=666).Results All 62 cases achieved primary successful sheath placement(success rate 100%).Mean stone diameter was(15.4±4.2)mm and mean CT attenuation(1215±285)HU.SFR on day 1 was 95.2%,peri-operative complications were all Clavien grade Ⅰ-Ⅱ,mean post-operative stay was(2.6±0.9)days.Dur-ing the 3-6 month follow-up,the SFR was 100%and no ureteral stricture or severe hydronephrosis occurred.Compared with the pooled literature values,the operative time was shortened[(58.6±12.8)min vs.(66.0±14.5)min,t=6.13,P=0.002],the SFR increased(95.2%vs.88.5%,χ2=6.58,P=0.010),the complication rate was reduced(4.8%vs.9.4%,χ2=4.31,P=0.038),and all differences were statistically significant.Conclusions Single-use FURS combined with ASS in the treatment of impacted ureter-al calculi offers significantly superior outcomes in literature comparisons and be used as the first-line minimally invasive treatment for impacted ureteral stones.However,further multi-center randomized controlled trials are needed to validate the long-term efficacy.