Clinical Study On The Application Of Triangular Bracket Tube In Flexible Ureteroscopic Lithotripsy

Objective:By comparing the clinical data of two ureteral stents after flexible ureteroscopic lithotripsy,the safety and effectiveness of the two ureteral stents were analyzed to provide reference for clinical decision-making.Methods: This study is a prospective case-control study.Patients who were diagnosed with urinary calculi and treated with flexible ureteroscope by the same surgeon in the Department of Urology,Shanghai Oriental Hospital from January 1,2020 to December31,2021 were included in the study.They were randomly(random table method)divided into experimental group(implanted with triangular double J tube,referred to as triangular double J tube)and control group(implanted with circular double J tube,referred to as circular double J tube).The basic clinical data of the two groups were statistically analyzed.Including the patient ’s gender,age,previous ipsilateral surgery history,stone course,stone maximum diameter,degree of hydronephrosis,stone CT value,operation time,whether combined with ureteral stenosis or polyps,postoperative KUB to determine the position of stent tube,whether double J tube displacement or shedding,operation to stent removal time,stone clearance rate at 2 weeks after operation,USSQ urinary tract symptom score,somatic pain symptom score,general health status score,sexual function score,whether double J tube has stone attachment and the quality of stone attachment,CT review at 3 months after operation to understand whether hydronephrosis and stone clearance rate at 3 months after operation.Statistical software SPSS 25.0 was used to analyze the data of the two groups.Results:A total of 72 patients were collected.There were 33 cases in the experimental group,including 25 males and 8 females,with an average age of 61.8 ± 16.4 years.There were 9 cases with a history of ipsilateral surgery,and the maximum diameter of stones was 1.41 ± 0.35 cm.There were 14 patients with stones in the upper ureter and renal pelvis,10 in the upper calyx,3 in the middle calyx,and 6 in the lower calyx.The CT value of stones was 1024 ± 222.2Hu,and the hydronephrosis was 11.1 ± 11.9mm.There were 39 patients in the control group,including 22 males and 17 females,with an average age of54.8 ± 14.0 years.There were 12 patients with a history of ipsilateral surgery.The maximum diameter of the stones was 1.29 ± 0.21 cm.There were 10 patients with stones in the upper ureter and pelvis,11 in the upper calyx,8 in the middle calyx,and 10 in the lower calyx.The CT value of the stones was 1039 ± 281.4Hu,and the hydronephrosis was 8.5 ± 12.0mm.In the experimental group,25 cases(75.8 %)had no obvious residual stones at 2 weeks after operation,and 24 cases(61.5 %)had no obvious residual stones at 2 weeks after operation in the control group.The time of stent removal was 28.6 ± 11.7days in the experimental group and 35.2 ± 13.2 days in the control group,with significant statistical difference.There was no significant difference in safety between the experimental group and the control group(including whether there was double J tube displacement or shedding,USSQ urinary tract symptom score,body pain symptom score,general health status score,sexual function score 2 weeks after operation,antibiotic use time before stent removal,and fever before stent removal).Conclusions: The application of triangular double J tube in the auxiliary stone removal after flexible ureteroscopic lithotripsy can significantly improve the short-term stone clearance rate after operation,and has similar safety to the traditional circular double J tube,without significantly increasing stent-related complications.