Presentation Authors: José Salvadó*, Rodrigo Sanchez, José Cabello, Renato Cabello, Sergio Moreno, Álvaro Kompatzki, Ruben Olivares, Alfredo Velasco, Santiago, Chile
Introduction: Advances in the design of flexible ureteroscopes have recently led to the emergence of single use equipment. This type of technology allows to use an absolutely new endoscope in each case, saving resources with respect to maintenance, replacement and sterilization among others. The aim of the present study was to compare the clinical results achieved with the use of 2 types of disposable equipment: Lithovueïƒ’ (Boston Scientific) versus USCOPE 3022ïƒ’ (Pusen)
Methods: A prospective comparative study was performed using information registered in a database of our center. The clinical outcomes obtained between October 2016 and August 2018 from patients undergoing flexible ureteroscopy for upper urinary tract stone treatment were included in the analysis. The first group underwent surgery utilizing USCOPE 3022 flexible ureteroscope and the second group used Lithovue flexible ureteroscope . The variables analyzed included: total surgery time, fluoroscopy time, post-procedure ureteral catheter requirement, stone free rate and complications among others. The results were evaluated using Student's t test, Mann-Whitney test and Fisher's test.
Results: There were 97 cases with the Uscope 3022 and 40 cases with Lithovue included in thi study. Both groups were comparable in their demographic and clinical variables, including: stone size, location and measurement of Hounsfield units, as well as the presence of double j stent prior to the procedure. Regarding the clinical results, multivariated analysis showed no difference with respect to stone free rate ,92.8% (Lithovue), 91.4% (USCOPE 3022), p = 0.7, need for post procedure double J stent , complications or hospital stay. Significant differences were found for the total surgery time, 45 vs 35 mins (p = 0.04), as well as for the fluoroscopy time 50 vs 20 sec (p < 0.01), both in favor of Lithovue group. There were no problems regarding to the performance of this two types of single use ureteroscopes, such as loss of deflection or image quality.
Conclusions: This study shows that both devices are highly effective in achieving an adequate treatment of kidney stones. The reason for difference in total surgery and fluoroscopy time, favorable to Lithovue, are not clear. However, one explanation for this finding could be the better optical resolution, deflection capacity, field of view an irrigation flow compared to USCOPE 3022, as was shown in previous reports.