aDepartment of Urology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China bXie Urology, Margate, FL, USA cLiaobu Township Community Health Service Center, Dongguan, Guangdong, China dGan County District Dermatology Institute, Ganzhou, Jiangxi, China
Objective: The purpose of the study was to assess the clinical efficacy and safety of a combined perfusion suction platform with pressure feedback control function and an ureteroscopic suction sheath that can measure the ureteropelvic pressure in implementing lithotripsies. Methods: Fifty-two patients who underwent lithotripsy under intelligent monitoring of ureteral intraluminal pressure from June 2016 to January 2018 were retrospectively recruited. The inclusion standard was stone diameter >1.5 cm but <2.5 cm. After the 12/14 Fr suction sheath was placed, manometer interface and suction interface of the sheath were connected to the platform via the pressure sensor and suction tube, respectively. The ureteroscope was connected to the platform perfusion pump, and the crushed stones were aspirated out under negative pressure. Results: According to the location of the stone, 21 (40.4%) cases were classified as upper ureteral stones, 19 (36.5%) were midureteral stones, and 12 (23.1%) were lower ureteral stones. Forty-seven patients underwent successful primary sheath placement and lithotripsy with a mean operative time of 34.5 (standard deviation 18.3) min. Retrograde stone migration did not occur. There were eight patients with hematuria postoperatively. Serious complication was 1.9% with one case of ureteral perforation. Stone clearance was 95.7% at Day 1-2 postoperatively, and 100% at Day 30 postoperatively. Conclusion: Ureteroscopic lithotripsy with intelligent pressure control using our device improved the efficiency of the lithotripsy and rate of stone clearance. The safety of the operation can be ensured. It is worth popularization and application in clinical practice.
Complication (Clavien-Dindo categorization), n (%)
Hematuria (Clavien Grade I)
8 (17.0)
Stone upward migration (Clavien Grade III)
0
Ureteral extravasation (Trexer Grade III)
1 (2.1)
Postoperative hospitalization duration, mean±SD, day
2.1±1.1
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