Clinical Study of Tubeless Percutaneous Nephrolithotomy Using a Flexible Negative Pressure Suction Sheath Combined with a Flexible Ureteroscope for the Treatment of Renal Calculi
Liu Lifeng
Cao Na
Guo Yansong
Wang Hao
Wang Xiaopeng
Fan Shuncheng
Chen Baochun
Tian Longjiang
Yang Fengshuo
Abstract：Objective:To investigate the efficacy and safety of a tubeless postoperative management approach following the treatment of renal calculi using a flexible ureteroscope combined with a deflectable negative pressure at-traction sheath.Methods:A total of 90 patients with renal calculi admitted to Cangzhou People's Hospital from Janu-ary 2023 to June 2024 were enrolled,with 85 patients ultimately included in the study.All patients underwent holmi-um laser lithotripsy using a flexible ureteroscope combined with a deflectable negative pressure attraction sheath.Pa-tients were randomly assigned to either a tubeless group(n=42)or a traditional double-J stent placement group(con-trol group,n=43).The stone clearance rate,ureteral obstruction rate,pain and comfort levels,inflammatory mark-ers,and postoperative complications were compared between the two groups.Statistical analyses were performed us-ing t-tests,ANOVA,and χ2 test.Results:The stone clearance rate at 24 hours postoperatively was 95.24%(40/42)in the tubeless group and 95.35%(41/43)in the control group,with no significant difference between the two groups(P>0.05).No ureteral dilation or obstruction occurred in either group.At 24,48,and 72 hours postoperatively,the Visual Analog Scale(VAS)scores for pain were significantly lower in the tubeless group compared to the control group(P<0.05),while the Bruggrmann comfort scores were significantly higher in the tubeless group(P<0.05).At 24 hours postoperatively,both groups showed elevated white blood cell count(WBC),procalcitonin(PCT),and C-reactive protein(CRP)levels compared to preoperative values(P<0.05),but these levels were significantly lower in the tubeless group compared to the control group(P<0.05).The overall postoperative complication rate was 21.43%(9/42)in the tubeless group and 44.19%(19/43)in the control group,with a statistically significant difference(P<0.05).Conclusion:Tubeless postoperative management following the treatment of renal calculi using a flexible ure-teroscope combined with a deflectable negative pressure attraction sheath does not affect the stone clearance rate or ureteral obstruction rate.It also reduces postoperative pain,lowers inflammatory responses,and decreases the inci-dence of complications.Additionally,it eliminates the need for cystoscopy for stent removal,thereby reducing the economic burden on patients.This approach is safe and feasible.
Keywords：distally flexible suction sheathkidney calculitubeless techniqueflexible ureteroscopes
Publication Date：2025-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 161-166 )