A Randomized Controlled Study Of Multi-person Take Turns Operation And Single-person Operation In Flexible Ureteroscopic Lithotripsy

Objective:To compare multi-person take turns operation and single-person operation different impact on results of operations and operator comfort in flexible ureteroscopic holmium laser lithotripsy.Methods:From June2014to December2014,65patients who were admitted to one medical team of Sir Run Run Shaw Hospital were treated with flexible ureteroscopic holmium laser lithotripsy. They were randomized in multi-person take turns operation group (n=35) and single-person operation group (n=30). Compare the operative time, blood loss, hospitalization days after operation, stone free rate, fragmentation speed, postoperative complications and doctor’s score on eyes and forearm fatigue level.Results:The two groups had no significant difference in age, gender, illness side, stone size, the number of cases whose stone involving the lower calyx.(P>0.05) There was no significant difference between two groups in blood loss, operative time, postoperative hospitalization days, stone free rate.(P>0.05) One case of single-person operation group bled in prostate after operation and others recovered well with no significant complication. The fragmentation speed of multi-person take turns operation group and single-person operation group were:46.13±27.92mm3/min and33.66±14.62mm3/min; visual fatigue score:2.93±1.71and4.67±2.19; forearm fatigue score:2.11±1.08and3.33±1.32were statistically significant (P<0.05).65cases divided into four subgroups according to the fragmentation time. When the fragmentation time was less than or equal to45min, two groups’ visual fatigue score and forearm fatigue score showed no significant difference (P>0.05). However when the fragmentation time was more than45min, two groups’ visual fatigue score and forearm fatigue score showed significant difference (P<0.05).Conclusion:In flexible ureteroscopic holmium laser lithotripsy, multi-person take turns operation can improve the fragmentation speed and also can significantly lower operator fatigue level, improve operator comfort when fragmentation time is longer than45minutes.