Effect of zebra guidewire preservation during ureteroscopy on reduction of ureteral injury

Abstract

Objective To investigate the effect of zebra guidewire preservation during ureteroscopy on reducing the occurrence of complications and to ensure a successful procedure.Methods 240 patients with ureteral calculi were randomly divided into study group and control group,120 for each group.The ureteroscope was guided by zebra guidewire to the ureter.In the study group as the ureteroscope arrived at stone site zebra guidewire across the stones and perservated in the ureter,exiting the ureteroscope and then insert it into the ureter again and use holmium laser to crush the stone,while in the control group as the ureteroscope arrived at the position of stones exiting the zebra guidewire and direct crushed the stones.The efficacy was observed in the two groups.The success rate of surgery,rate of stones shifted into the pelvis,rate of ureteral tract loss,and ureteral injury rate were analyzed and compared between the two groups.Results In the study group,120 patients were successful,with a rate of 100.0％;while in the control group,100patients were successful,with a rate of 83.3％,and with a significant difference(P＜0.05).In the study group with the upper section,14 shifted into the renal pelvis,with a rate of 25％,and with the middle and lower section,4 shifted into the renal pelvis,with a rate of 6.25％;in the control group with the upper section,24 shifted into the renal pelvis,with a rate of 48％,and with the middle and lower section,9 shifted into the renal pelvis,with a rate of 12.9％,and with a significant difference(P＜0.05).No ureteral tract loss occurred in the study group,while 15 developed ureteral tract loss in the control group,with a rate of 12.5％,and with a significant difference(P＜0.05).In the study group,4 patients developed ureteral injury,with a a rate of 3.3％,whereas 14 developed ureteral injury in the control group,with a rate of 11.7％,and with a significant difference(P＜0.05).Conclusions Zebra guidewire preservation in the ureter during ureteroscopy can reduce the complications and ensure successful procedures and made the surgery more safe and effective. Key words: Ureteroscopy; Lithotripsy; Zebra guidewire; Complications