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Two Types of Single-use Flexible Ureteroscopies for the Treatment of Upper Urinary Tract Stones in Children

Not Applicable
Recruiting
Conditions
Urinary Stone
Interventions
Device: 8.6 Fr single-use fURS (XFGC-FU-660RC)
Device: 6.3 Fr single-use fURS (Hugemed, HU30S)
Registration Number
NCT06628765
Lead Sponsor
The Children's Hospital of Zhejiang University School of Medicine
Brief Summary

The single-use digital flexible Ureteroscopy (fURS) is commonly used for the treatment of upper urinary tract stones. The size of the outer diameter of the fURS can affect the safety, efficacy, and medical costs of the treatment. Particularly for children, their ureters are thinner and more tortuous compared to adults, which places higher demands on medical devices. The investigators are interested in determining if the performance of the two different sizes of fURS (6.3 Fr vs. 8.6 Fr) are equivalent. This study will have guiding significance for the selection of upper urinary tract stones surgery in children in the future.

Detailed Description

The single-use digital fURS is a sterile, disposable, flexible endoscope. Compared to traditional reusable digital flexible endoscopes, single-use digital fURS has lower maintenance costs, is easier to operate, and effectively avoids cross-infection between patients. With technological advancements, the size of single-use digital fURS has become increasingly slim, making them particularly suitable for children with narrow and tortuous ureters who suffered urinary stones. Currently, the single-use digital fURS used in our unit has an outer diameter of 8.6Fr. For younger children, the success rate of the first insertion of the fURS is still relatively low. When the fURS cannot pass through the ureter, it is necessary to actively dilate the ureter with a balloon in one stage, or passively dilate it with a urethral stent during the procedure to facilitate a second-stage fURS procedure. This not only increases the risk of ureteral injury but also incurs additional medical expenses. Recently, HugeMed Company has launched a single-use digital fURS with an outer diameter of 6.3 Fr, which is currently the thinnest single-use fURS in the world, and its effectiveness and safety have been preliminarily verified in clinical practice. The purpose of this study is to compare the safety and efficacy of the 6.3 Fr fURS (HU30S) and the 8.6 Fr fURS (XFGC-FU-660RC) in the clinical treatment of upper urinary tract stones in children.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
52
Inclusion Criteria
  • Patients scheduled for ureteroscopy and laser lithotripsy for individual renal stones ranging in size from 5 mm to 20 mm in all intrarenal locations (If there are multiple stones present, the total stone burden in cross section should not exceed 20 mm)
  • Patients < 14 years
  • For children younger than 8 years old, the informed consent form is signed by the parents; for children older than 8 years old, the informed consent form is signed by both the parents and the child themselves.
Exclusion Criteria
  • Children with uncontrolled urinary tract infections or coagulation disorders and other contraindications for surgery before the operation.
  • Children with severe renal insufficiency, anatomical or functional solitary kidney, known nephrocalcinosis, and other significant comorbidities that are not suitable for participating in the study.
  • Children who refuse to participate in this study.
  • Any other reason that in the opinion of the investigator would make the participant unsuitable for enrollment in the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
8.6 Fr single-use fURS (XFGC-FU-660RC)8.6 Fr single-use fURS (XFGC-FU-660RC)-
6.3 Fr single-use fURS (HugeMed, HU30S)6.3 Fr single-use fURS (Hugemed, HU30S)-
Primary Outcome Measures
NameTimeMethod
The success rate of the first fURS insertionDuring the procedure

The first insertion of fURS is successful without the need for balloon dilation or passive dilation with a stent.

Secondary Outcome Measures
NameTimeMethod
Ureteral access sheath placement (Yes/No)During the procedure

Whether a ureteral access sheath is placed during the procedure

Balloon dilation rateDuring the procedure

Due to difficulty in passing the fURS through the ureter, balloon dilation of the ureter is performed during the procedure

Pre-placement rate of double-J stentsDuring the procedure

Due to difficulty in passing the fURS through the ureter, the double-J stent is placed during the surgery to passively dilate the ureter, facilitating a second-stage fURS procedure

Surgical durationDuring the procedure

From the initiation of fURS insertion to the completion of lithotripsy, the fURS is withdrawn from the body

Blood lossDuring the procedure

Intraoperative blood loss

Indwelling catheter durationThree days postoperatively

Indwelling catheter duration postoperatively

Postoperative hospital stayUp to one week postoperatively

Postoperative hospital stay

Perioperative complicationsThrough study completion, up to two months postoperatively

Pain (e.g. dysuria and lumbar pain), Hematuria, Frequency and urgency of urination, Fever

Stone-free rate at 4 weeks postoperatively4 weeks postoperatively

Stone-free status was evaluated at 4-week and defined as a single residual fragment ≤2 mm

Trial Locations

Locations (1)

Children's hospital, Zhejiang University School of Medicine

🇨🇳

Hangzhou, Zhejiang, China

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