Study On The Value And Application Strategy Of RIRS In The Diagnosis And Treatment Of "Aviator Pilot Renal Calculi"

Objective:Part Ⅰ: To explore the surgical timing,diagnostic and therapeutic value of RIRS in the diagnosis and treatment of " Aviator Pilot Renal Calculi ",as well as the skills and precautions during the operation.Part Ⅱ: To explore the related complications and impact on renal function in the application of RIRS towards "Aviator Pilot Renal Calculi".Methods:A retrospective analysis was performed to summarize the preoperative CTU results,intraoperative conditions,and postoperative identification of 36 patients with "Aviator Pilot Renal Calculi" who underwent RIRS in our hospital from February 2017 to December 2019.The first part: Evaluate the value of RIRS diagnosis and treatment;explore the treatment timing,surgical techniques and surgical precautions.The second part: Compare the preset ureteral stent group and the non-preset ureteral stent group,as well as intraoperative conditions and postoperative complications,etc.;compare creatinine u NGAL、u TWEAK、s Cys-C、s TWEAK before and after operation,to understand the impact of RIRS on renal function,and to further investigate the safety of RIRS and the prevention for complications.Results:Part Ⅰ: Among the 36 patients,all lesions were clearly diagnosed and treated after RIRS,and all patients were qualified in the aviator physical examination.Part Ⅱ: Among all patients with non-preset ureteral stents,3patients had varying degrees of complications.Including: change to two-stage operation,ureteral perforation and renal subcapsular hematoma and so on.Before and after the operation u NGAL、u TWEAK、s Cys-C、s TWEAK increased transiently,and recovered to the preoperative level in accordance with one month review after operation.Conclusion:In the " Aviator Renal Calculi " found by CTU,the situation is complicated.High-density shadows are not only possible with stones,but also with calcified foci and diverticulum stones.Since it may be combined with anatomical abnormalities,stone incarceration and other conditions,conservative treatment is not appropriate.It is thus recommended a RIRS after a period-time trial of spontaneous passage,due to timely diagnosis and treatment.Therefore,it can shorten the diagnosis and treatment cycle,which is conducive to an early return to flight.RIRS is safe and has no effect on renal function.Preoperatively preset ureteral stent is beneficial to intraoperative operation and can minimize the incidence of complications.