Study on the efficacy and safety of PT Scope combined with Thulium laser in the treatment of upper urinary tract stones
Objective To evaluate the feasibility and safety of PT Scope(short for intelligent pressure and temperature controlled flexible ureteroscopy)combined with Thulium laser in the intracavitary treatment of upper urinary tract stones.Methods A retrospective analysis was conducted on the clinical data of 13 patients with upper urinary tract stones who were treated with PT Scope combined with Thulium laser lithotripsy in Sun Yat-Sen Memorial Hospital from February to April 2024.There were 7 males and 6 females.The patients had a mean age of(46±10)years old,with an accumulated stone diameter of(25.8±13.3)mm.There were 7 cases of lower calyx stones(53.8％),and 3 cases of concomitant ureteral stones(23.1％).Four patients(30.8％)had positive preoperative urine cultures,and six patients(46.2％)had leukocyte counts greater than 100 cells/μl in their urine tests.The Thulium laser power was set at 45 W(1.5 J at 30 Hz,0.3 J at 150 Hz).The renal pelvic pressure threshold was set at 30 mmHg(1 mmHg=0.133 kPa),and the temperature threshold at 43 ℃.Postoperatively,double J stents were placed for 2 to 4 weeks.Results All 13 patients successfully completed the surgery.The median operative time was 30(25,90)minutes.The intraoperative average renal pelvic pressure in these 13 patients ranged from 8 mmHg to 24 mmHg,and the average renal pelvic temperature ranged from 25 ℃ to 34 ℃.Postoperatively,1 patient experienced a fever(38.0 ℃)and 2 patients required analgesic treatment due to postoperative pain.There were no other intraoperative or postoperative complications.The median postoperative hospital stay was(1.5±0.8)days.The stone-free rate of 1 month was 84.6％(11/13).Conclusions PT Scope combined with Thulium laser could effectively control renal pelvic pressure and temperature,achieve a high stone-free rate,and have a low complication rate.It is a safe and effective treatment for upper urinary tract stones.
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