Comparative Analysis Of Upper Ureteral Calculus Treated With Holmium Laser With Single-use Flexible Ureteroscopes And Ureteroscopic Holmium Laser

Objective: The clinical efficacy,complications,cost and stone clearance rate of single-use soft ureteroscope and hard ureteroscope holmium laser in the treatment of upper ureteral calculi were compared,so as to provide a more appropriate treatment for patients.Methods: Eighty-eight patients diagnosed with upper ureteral calculi in the Fourth Clinical College of Hubei University of Medicine from March 2020 to December2021 were retrospectively analyzed.According to the different ureteroscopy,the patients were di vided into two groups: 41 patients in the Su-Furs group were treated with Olympus single-use flexible ureteroscopic holmium laser lithotripsy,and 47 patients in the RURS group were treated with Olympus hard ureteroscopic holmium laser lithotripsy.The age,gender,body mass index(BMI),stone size,stone side,hydronephrosis,Stone free rate(SFR),operation time,total length of stay,hospitalization cost,postoperative complications and other indicators of the group SU-FURS and group RURS were analyzed statistically and compared.Results:(1)Comparison of general data: the group SU-FURS and group RURS do not have statistically significant differences between the preoperative indicators such as age,gender,body mass index,maximum diameter of stone,stone side,and have hydronephrosis or not(P > 0.05).(2)Comparison of operation time: the average operation time was51.05±11.20 min in the SU-FURS group and 68.72±17.27 min in the RURS group,and the difference between the group SU-FURS and group RURS was statistically significant(P < 0.05).(3)Comparison of hospitalization days: the hospitalization days of SU-FURS group was 6.32±1.26 days,and that of RURS group was 6.02±1.47 days,the difference between the group SU-FURS and group RURS was not statistically significant(P > 0.05).(4)Total hospitalization cost was 23537.32±1357.95 yuan in the SU-FURS group and 14039.30±1269.89 yuan in the RURS group,the difference between the group SU-FURS and group RURS was statistically significant(P < 0.05).Comparison of stone clearance rate: there was no statistical significance between the group SU-FURS and group RURS in stone free rate(P > 0.05).(5)Comparison of postoperative complications: Among the 41 patients in the Su-Furs group,6 patients had postoperative fever,1 patient had urinary sepsis,9patients had hematuria,and 11 patients had lumbar and abdominal pain.Among the 47 patients in RURS group,4 patients had postoperative fever,1patients had urinary sepsis,16 patients had hematuria,and 22 patients had lumbar and abdominal pain.Statistical analysis of complications showed no significant difference between the group SU-FURS and group RURS(P > 0.05).The overall complications of the group SU-FURS and group RURS were statistically analyzed,and the difference between the group SU-FURS and group RURS was statistically significant(P < 0.05).(6)With gender as grouping condition,operation time,length of stay,cost,SFR and complication rate were compared between the group SU-FURS and group RURS,and there was no statistical significance(P > 0.05).Conclusion:(1)In the treatment of upper ureteral calculi,disposable flexible ureteroscope has shorter operation time than repeated hard ureteroscope,and is a disposable material,which is more conducive to new patients’ learning of surgery.(2)In the treatment of upper ureteral calculi,single-use flexible ureteroscopy is more expensive than repeat hard ureteroscopy.(3)In the treatment of upper ureteral calculi,single-use flexible ureteroscopic holmium laser has a lower complication rate than hard ureteroscopic holmium laser.(4)In the treatment of upper ureteral calculi,there was no gender difference in the indexes of ureteroscopic lithotomy.