Comparison Between Single-Use Flexible Ureteroscope and Reusable Flexible Ureteroscope for Upper Urinary Calculi: A Systematic Review and Meta-Analysis.

Chunyang Meng,Lei Peng,Jinming Li,Jinze Li,Ji Wu,Yunxiang Li

doi:10.3389/fsurg.2021.691170

Abstract

Objective: This article explores the differences in the effectiveness and safety of the treatment of the upper urinary calculi between single-use flexible ureteroscope (su-fURS) and reusable flexible ureteroscope (ru-fURS).Methods: We systematically searched PubMed, Embase, Cochrane Library, Scopus database, and CNKI databases within a period from the date of database establishment to November 2020. Stata 16 was used for calculation and statistical analyses.Results: A total of 1,020 patients were included in the seven studies. The statistical differences were only found in the Clavien–Dindo grade II postoperative complication [odds ratio (OR) 0.47; 95% CI 0.23–0.98; p = 0.04]. No significant statistical differences were observed in operative time (OT), estimated blood loss (EBL), length of hospital stay (LOS), and stone-free rate (SFR).Conclusion: Our meta-analysis results demonstrate that su-fURS, compared with ru-fURS, has similar effectiveness and better security for treating upper urinary calculi.

Highlights

Urolithiasis is one of the most common diseases in urology, which has a high incidence in the world
Search terms included: “ureteroscope,” “flexible ureteroscope,” “single-use,” “disposable,” “reusable,” “upper urinary calculi,” “kidney stone,” “ureteral calculi,” and the search was not restricted by language
Studies meeting the following inclusion criteria were listed as follows: [1] patients diagnosed as upper urinary calculi by a urologist; [2] comparison of single-use flexible ureteroscope (su-fURS) with ru-fURS; [3] any size of the stones and a similar number of surgeries; [4] full papers containing at least one outcome parameters such as operative time (OT), estimated blood loss (EBL), length of hospital stay (LOS), stone-free rate (SFR), and complications; and [5] the type of articles should be a prospective controlled study, cohort study, retrospective study, or randomized controlled study

Summary

Introduction

Urolithiasis is one of the most common diseases in urology, which has a high incidence in the world. Kidney stones can lead to renal colic, urinary tract infection, and obstruction and are risk factors for chronic kidney disease [2]. The treatment of upper urinary calculi has always been the focal point of medical research. Surgical treatment was the main treatment method of the upper urinary tract stone. Open surgery was highly traumatic and could only be used for some special patients. Percutaneous nephrolithotomy has the highest rate of surgical exclusion for large stones and multiple kidney stones. Tubeless minimally invasive percutaneous nephrolithotomy may be a probable choice for strictly chosen patients [3]. The flexible ureteroscopes (f-URSs) were taking an essential role in recent years and the new thulium laser system during ureteroscope was giving interesting results [4]

Methods

Results

Discussion

Conclusion