Two-shift operation mode can improve the efficiency and comfort of flexible ureteroscopic holmium laser lithotripsy for the treatment of renal calculi larger than 1.5cm

Int Braz J Urol. 2019 Nov-Dec;45(6):1161-1166. doi: 10.1590/S1677-5538.IBJU.2019.0219.

Abstract

Purpose: To compare two-shift operation mode and single player mode different impact on surgical results and operator comfort in flexible ureteroscopic holmium laser lithotripsy for renal calculi larger than 1.5cm.

Materials and methods: From december 2017 to december 2018, 92 patients with renal calculi admitted to Qilu Hospital and were treated through fl exible ureteroscopy. They were randomized in two-shift group (n=50) and single player group (n=42). The operative time, blood loss, hospitalization stay after operation, residual fragments (≥4mm) rate, fragmentation speed, postoperative complications and operator's fatigue score were compared.

Results: There was no significant difference between two groups regarding age, gender, illness side, stone size, blood loss, operative time, postoperative hospitalization stay, complications, etc (p >0.05). The fragmentation speed was 44.5±20.0mm3/min in two-shift group compared with 34.2±17.3mm3/min in single player group (p=0.037). Residual fragments (≥4mm) rate after fi rst surgery was 18% in two-shift group, while the residual fragments (≥4mm) rate was 40.5% after first surgery in single player group (p=0.017). The total fatigue score of two-shift group was 8.4 compared to 29.9 in single player group (p <0.001).

Conclusion: In flexible ureteroscopic holmium laser lithotripsy for the treatment of renal calculi larger than 1.5cm, two-shift operation mode can raise the fragmentation speed and stone clearance rate, as well as signifi cantly lower operator's fatigue level and improve operator's comfort.

Keywords: Kidney Calculi; Lithotripsy, Laser; Ureteroscopy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Equipment Design
  • Ergonomics
  • Female
  • Humans
  • Kidney Calculi / pathology
  • Kidney Calculi / surgery*
  • Lasers, Solid-State / therapeutic use*
  • Length of Stay
  • Lithotripsy, Laser / instrumentation
  • Lithotripsy, Laser / methods*
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications
  • Reproducibility of Results
  • Treatment Outcome
  • Ureteroscopy / instrumentation
  • Ureteroscopy / methods*