Ureteroscopic holmium laser lithotripsy in treatment of middle or lower ureteral calculi: a report of 70 cases
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摘要: 目的:探讨输尿管镜钬激光碎石术治疗输尿管中下段结石的有效性及安全性。方法:应用硬性输尿管镜联合钬激光碎石术治疗输尿管中下段结石70例,其中中段结石26例,下段结石44例。结石合并急性肾绞痛8例,合并输尿管息肉22例,合并输尿管狭窄5例。结果:单次碎石成功67例,成功率95.7%。1例因输尿管开口水肿狭窄导致置镜困难,1例术中结石移位至肾脏,1例结石息肉包裹改开放手术。术中发生输尿管穿孔4例,术后并发泌尿系感染1例,经积极抗感染治疗后痊愈。随访2~6个月,无结石残留及输尿管狭窄发生。结论:输尿管镜钬激光碎石术治疗输尿管中下段结石具有高效、微创、安全等优点,是输尿管中下段结石首选的治疗方法。Abstract: Objective: To investigate the efficacy and safety of ureteroscopic holmium laser lithotripsy in treatment of middle or lower ureteral calculi.Methods: Holmium laser lithotripsy was conducted in 70 cases of middle and lower ureteral calculi via rigid ureteroscope.There were 26 cases with middle ureteral calculi and 44 cases with lower ureteral calculi.Acute renal colic was occurred in 8 cases.Polyp was found in 22 cases and ureteral stenosis was found in 5 cases.Results: The successful lithotripsy in a single procedure was achieved in 67 cases and the success rate was 95.7%.Failure of ureteroscopy placement occurred in one case because of stricture of ureteral orifice.Calculi was translocated to renal pelvis in one case.Conversion to open surgery was occurred in one case because of polyp package of ureteral calculi.Ureteral perforation was occurred in 4 cases and urinary tract infection was occurred in one case who was recovered after use of antibiotics.There was no ureteral stenosis or calculous remnant happening after following-up of 2 to 6 months.Conclusions: Treatment of ureteral calculi by ureteroscopic holmium laser lithotripsy is an effective,less invasive and safe method.It should be the preferred way to patients with lower or middle ureteral calculus.
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Keywords:
- ureteral calculus /
- ureteroscope /
- lithotripsy /
- laser
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