Clinical application of flexible ureteroscope combined with flexible terminal suction ureteral access sheath in treatment of impacted ureteral calculi with a diameter of ≥1.5 cm
Objective:To investigate the safety and efficacy of flexible ureteroscope combined with flexible terminal suction ureteral ac-cess sheath in the treatment of impacted ureteral calculi with a diameter of ≥1.5 cm,and to summarize related clinical experience.Methods:A retrospective analysis was performed for the clinical data of 27 patients with impacted ureteral calculi with a diameter of ≥1.5 cm who received flexible ureteroscope combined with flexible terminal suction ureteral access sheath in The First Affiliated Hospital of Guangxi Medical University from January 2023 to February 2024.Results:A total of 27 patients were enrolled,among whom there were 23 male patients and 4 female patients,with a mean age of(48.4±15.4)years and a mean body mass index of(23.7±3.2)kg/m2.Of all 27 patients,19 had ureteral calculi at the left side and 8 had ureteral calculi at the right side.The CT value of stones was(1097.6±268.7)HU.The mean length and width of calculi were(1.8±0.3)cm and(0.9±0.2)cm,respectively.As for the location of calculi,24 patients had upper ureteral calculi,2 had middle ureteral calculi,and 1 had lower ureteral calculi.There were 5 patients with ipsilateral renal calculi and 22 without renal calculi.The mean depth of hydronephrosis was(4.7±1.8)cm.There were 2 patients with negative preoperative urine white blood cells,13 with weakly positive(+)urine white blood cells,7 with positive(++)urine white blood cells,and 5 with strongly positive(+++)urine white blood cells.A total of 25 patients completed flexible ureteroscopy,and 2 patients changed the surgical procedure during surgery,with a mean time of operation of(86.7±46.4)minutes and a mean length of hospital stay of(3.1±1.7)days.The levels of white blood cells and hemoglobin were(8.0±2.4)×109/L and(135.1±21.4)g/L,respec-tively,before surgery,and(8.9±2.5)×109/L and(135.9±17.8)g/L,respectively,on day 1 after surgery.Reexamination on day 1 after surgery showed that 22 patients had no residual stones,while 5 had residual stones.The mean body temperature on the day after surgery was(36.2±0.2)℃,with no clinical manifestations of urinary sepsis.Conclusion:Flexible ureteroscope combined with flexible terminal suction ureteral access sheath is safe and effective in the treatment of impacted ureteral calculi with a diameter of ≥1.5 cm,with a relatively high stone clearance rate and a relatively low incidence rate of complications.
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