| purpose:Evaluate the predictive power of preoperative CT values of renal calculi above 2 cm in determining the efficacy of FURL treatment by analyzing the correlation between the CT values of kidney stones and eficiency of FURL treatments.Materials and Method:The clinical data of patients with renal calculi treated by ureteroscope holmium laser lithotripsy from May 2015 to December 2018 in our hospital were retrospectively analyzed.51 patients with single-sided solitary stones with a longest diameter greater than 2 cm were selected for further analysis.For each patient,the maximum CT value of the kidney stone,volume of the stone,FURL gravel time,and stone removal time were recorded.Stone gravel speed(stone volume/FURL gravel time)was calculated.The 51 patients were divided into 3 groups based on the stone gravel speed:group A(inefficient,low stone gravel speed),group B(medium efficiency,medium stone grave;speed),group C(high efficiency,fast stone gravel speed).Statistical analysis was done on the maximum CT values of the stones,FURL gravel time,Stone gravel speeds,stone removal time,numbers of operations,postoperative stone clearance rates,and complications.Result:The maximum CT values of stones for the three groups were:(1454.9±87.2)HU for group A,(1169.6±65.4)HU for group B,(758.8±95.3)HU for group C,with the difference between groups being statistically significant(P<0.01).There were no significant differences in age,gender,longest stone diameter,stone volume,number of preoperative complications,or intraoperative and postoperative complications(P>0.05).The FURL gravel speeds between groups,((42.9±2.6)mm~3/min for group A,(82.8±7.3)mm~3/min for group B,and(153.6±17.8)mm~3/min for group C,also showed a statistically significant difference(P<0.01).Similarly,the FURL gravel times(86.4±21.6)min for group A,(41.4±12.9)min for group B,and(24.6±7.4)min for group C),as well as the stone removal times(60.5±9.6)min for group A,(36.1±5.7)min for group B,and(15.4±2.6)min for group C)were statistically significantly different(P<0.01).There was a significant difference(P<0.01)in the number of operations for groups A,B,and C(1.9,1,and 1 respectively).Finally,the stone clearance rate for groups A,B,and C was 73.3%,88.9%,100%,respectively.This difference was also statistically significant(P<0.05).Pearson correlation analysis showed a linear correlation between CT values and FURL gravel speed(r=-0.955),between CT values and stone gravel time(r=0.709),and between CT values and stone removal time(r=0.884).Conclusion:For renal calculi above 2 cm,FURL efficacy is closely correlated with the maximum CT values of the stones.Higher CT values,were correlated with slower gravel speeds,longer gravel times,and longer stone removal times.For Higher CT values,the efficiency of the lithotripsy is clearly reduced,the stone clearance rate is decreased,and multiple operations are often necesary.For lower CT values,the gravel efficiency is high,the operation time is short,and the stone removal rate is high.Therefore,for FURL operations on renal calculi above 2 cm,preoperational measurement of the maximum CT value of the stones can be used to predict the operation time,the efficiency ofthe operation,the number of the operations,and the stone removal rate.These predictions may help clinicians reduce the implications and lower the risk of the surgery.This method has applicational value,and deserves clinical promotion. |
PDF Full Text Request