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目的:初步评估电子软性输尿管镜(Olympus,URF-V)临床使用的耐久性。方法:回顾性分析2013年9月~2014年7月由同一术者使用电子软性输尿管镜对135例上尿路疾病患者进行的149次手术操作情况,记录手术总时间和辅助仪器使用的种类和时间、软镜的可视性和操作性以及维修和损坏等相关资料。结果:135例149次手术中,治疗肾结石127例次(85.2%),尿路上皮癌3例次(2.0%),上尿路狭窄4例次(2.7%),用于诊断15例次(10.1%)。术前预置双J管127例次(85.2%),术中使用输尿管送达鞘(ureter access sheath,UAS)141例次(94.6%)。134例次手术(90%,127例次为碎石,4例次为狭窄内切开,3例次为表浅性尿路上皮癌切除)使用200μm钬激光光纤;71例次(47.7%)手术使用套石篮或取石钳等工具;44例次肾下盏结石手术中采用结石移位的方法,占肾下盏结石患者的73.3%。用于治疗和诊断目的的软镜使用时间为6 167min和153min,平均46和10.2min。电子软性输尿管镜的最脆弱部分是偏转系统。结论:数字技术的出现是软性输尿管镜发展的一个里程碑。由经验丰富的资深外科医生进行手术,并配合使用多种软性输尿管镜辅助仪器,可显著提高电子软性输尿管镜的使用寿命。
OBJECTIVE: To evaluate the endurance of clinical use of electron soft ureteroscope (URF-V). Methods: A total of 149 surgeries performed on 135 patients with upper urinary tract diseases by the same surgeon from September 2013 to July 2014 were retrospectively analyzed. The total duration of surgery and the types of auxiliary instruments used were recorded And time, the visibility and operability of the soft mirror as well as maintenance and damage and other related information. Results: Among 135 surgical operations, 127 cases (85.2%) were treated with kidney stones, 3 cases with urothelial carcinoma (2.0%) and 4 cases with upper urinary tract stenosis (2.7%) were used in the diagnosis of 15 cases (10.1%). There were 127 cases (85.2%) preoperative double J tube preoperatively, and 141 cases (94.6%) of patients had ureter access sheath (UAS) during operation. One hundred and sixty-four patients underwent surgery (90%, 127 with gravel, 4 with stenotic incision and 3 with superficial urothelial carcinoma) using 200 μm holmium laser fibers; 71 (47.7% Surgical use of stone baskets or stone tools such as lithotripsy; 44 cases of lower calyceal calculus surgery in the use of stone displacement method, accounting for 73.3% of patients with calyceal calculus. The soft lenses used for therapeutic and diagnostic purposes were 6 167 min and 153 min, averaging 46 and 10.2 min. The most vulnerable part of electronic soft ureteroscopy is the deflection system. Conclusion: The emergence of digital technology is a milestone in the development of soft ureteroscopy. Surgery by a seasoned and experienced surgeon, with the use of a variety of soft ureteroscopy assisted instruments, can significantly improve the life of electronic soft ureteroscopy.