Objectives To compare the dusting efficiency and safety with basketing for treating renal stones ≤ 2 cm during flexible ureteroscopy (fURS). Materials and methods This study included 218 patients with renal stones ≤ 2 cm treated with fURS. Among them, 106 patients underwent dusting, and 112 patients underwent fragmentation with basket extraction. All patients were followed up for 3 months postoperatively. The operating time, lasing time, stone-free rate (SFR) and complication rate were compared. Results The mean stone size in the dusting group was 1.3 cm, whereas 1.4 cm in the basketing group. The mean operative time was significantly lower in the dusting group than in the basketing group (43.1±11.7 minutes VS 60.5±13.4 minutes, P <0.05), but the lasing time was significantly longer for the dusting group than for the basketing group (17.7±3.9 minutes VS 14.1±3.6 minutes, P <0.05). SFR was significantly higher in the basketing group immediately after the operation and follow-up after 1 month (76.8% vs 55.7%, P= 0.001 and 88.4% vs 78.3%, P = 0.045). However, the SFR was similar for both groups (88.8% in the dusting group vs. 90.2% in the basketing group) after 3 months postoperatively. There was no statistical difference in the complication rates between the two groups. Conclusions Dusting has advantages in shortening the operation time and reducing the operation cost, but the lasing time was longer compared with the basketing. Although there is no difference in long-term effect, basketing is superior to dusting in terms of short-term SFR. Moreover, dusting should be avoided in some special cases and basketing a better choice. Both techniques are effective for the treatment of renal stones ≤ 2 cm and choice depends on patient demographic and stone characteristics.
Objectives: The aim of this study was to investigate factors predicting spontaneous stone passage after flexible ureteroscopic lithotripsy ( fURS) for renal stones. Materials and Methods: This study included 239 patients with renal stones who underwent fURS using the dusting technique. The final outcome was evaluated 3 months postoperatively and the residual fragment status (RFs) was defined as any residual stone fragments greater than 2 mm. Univariate and multivariate analyses of possible predictive factors associated with spontaneous clearance of residual renal fragments were performed. Results:186 patients(77.8%) had achieved an stone-free status (SFs) and 53 patients(22.2%) were considered with RFs. Univariate analysis showed the stone location, stone number, stone size, stone CT value, IPA degree, the presence of hydronephrosis and stone covered with purulent substance were all associated with RFs (P<0.05). Multivariate logistic regression analysis showed that larger stone size (P=0.001),multiple stones (P=0.038) , the IPA of <45°(P=0.035) , the presence of hydronephrosis (P=0.045), the stone CT value ≥1000 (P=0.047) were all significantly associated with higher rates of residual stone after fURS. The stone covered with purulent substance was found to be the strongest predictor of RFs (P=0.027). However, the presence of lower pole stone had no significant influence on stone clearance after fURS (P=0.263). Conclusions: Stone number, stone size , an IPA of <45°, stone CT value ≥1000 HU, stone covered with purulent substance and presence of hydronephrosis are all predictive factors of the spontaneous clearance of residual renal fragments after fURS.
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