High stone-free rate immediately after suctioning flexible ureteroscopy with Intelligent pressure-control in treating upper urinary tract calculi
Xingjian Gao, Zedong Zhang, Xinwei Li, Weiping Cai, Bin Zheng, Yijin Lu, Hualong Zhao, Junhong You, Gangfeng Zheng, Weilong Bao, Yutong Lai, Yisong Lv
Abstract
BACKGROUND: The retrospective observational study aimed to evaluate the safety and efficacy of suctioning flexible ureteroscopy with Intelligent pressure-control (SFUI) on treating upper urinary tract calculi in a large cohort. METHODS: Between July 2020 and August 2021, 278 patients with upper urinary tract calculi who underwent SFUI in our hospital were enrolled. Outcomes were stone-free rate (SFR) in one session and one-month after SFUI treatment, and complications scored by the Clavien-Dindo classification. RESULTS: A total of 310 kidneys underwent SFUI were included. The median surgery time was 75 min (ranged 60-110 min). One session and one-month SFRs were 80.65% and 82.26%, respectively. The one-session SFR was ≧ 87% in patients with Guy's stone score of Grade I among stone size < 40 mm. Risk factors for unsuccessful stone-free in one session were stone history (adjusted odds ratio (aOR): 2.39, 95% confidence interval (CI): 1.21-4.73), stone size of 40-49 mm (aOR: 4.37, 95% CI: 1.16-16.45), Guy's stone score ≧ Grade II (Grade II, aOR: 3.54, 95% CI: 1.18-10.59; Grade III, aOR: 10.95, 95% CI: 2.65-45.25). The incidence of Clavien-Dindo grade II-III complication was 3.26%. Complication is associated with Guy's stone score III (aOR: 22.36, 95% CI: 1.81-276.36). CONCLUSION: SFUI shows good safety and efficiency on treating upper urinary tract calculi. Patients with stone size < 40 mm or Guy's stone score of Grade I have a high chance to reach stone-free after SFUI treatment.