Two-shift operation mode can improve the efficiency and comfort of flexible ureteroscopic holmium laser lithotripsy for the treatment of renal calculi larger than 1.5cm

Abstract

Purpose: To compare two-shift operation mode and single player mode different impact on surgical results and operator comfort in fl exible ureteroscopic holmium laser lithotripsy for renal calculi larger than 1.5cm. Materials and methods: From december 2017 to december 2018, 92 patients with renal calculi admitted to Qilu Hospital and were treated through fl exible ureteroscopy. They were randomized in two-shift group (n=50) and single player group (n=42). The operative time, blood loss, hospitalization stay after operation, residual fragments (≥4mm) rate, fragmentation speed, postoperative complications and operator's fatigue score were compared. Results: There was no signifi cant difference between two groups regarding age, gender, illness side, stone size, blood loss, operative time, postoperative hospitalization stay, complications, etc (p >0.05). The fragmentation speed was 44.5±20.0mm3/min in two-shift group compared with 34.2±17.3mm3/min in single player group (p=0.037). Residual fragments (≥4mm) rate after fi rst surgery was 18% in two-shift group, while the residual fragments (≥4mm) rate was 40.5% after fi rst surgery in single player group (p=0.017). The total fatigue score of two-shift group was 8.4 compared to 29.9 in single player group (p <0.001). Conclusion: In fl exible ureteroscopic holmium laser lithotripsy for the treatment of renal calculi larger than 1.5cm, two-shift operation mode can raise the fragmentation speed and stone clearance rate, as well as signifi cantly lower operator's fatigue level and improve operator's comfort.

Surgery and Postoperative Care of Patients Undergoing Percutaneous Nephrolithotomy under the Guidance of B-Ultrasound Based on Smart Internet of Things

“…Flexible ureteroscope holmium laser lithotripsy is used to treat kidney stones larger than 1.5 cm. The two-shift operation can improve the speed of lithotripsy and stone removal rate, significantly reduce the fatigue of the operator, and improve the comfort of the operator [ 7 ]. These studies provide some references for this article, but due to insufficient data in related studies and missing samples, the results of the experiment are difficult to reproduce and unconvincing.…”

Treatment of renal lower pole stones: an update

“…Also, there is no influence of obesity on its results. For stones with >15mm, though, fatigue could impact in the results and Hui et al suggests that this can be minimized by a two-shift operation which also would increase the clearance rates (51).…”