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首页> 外文期刊>Experimental and therapeutic medicine >Modular flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal and proximal ureteral calculi: A single-surgeon experience of 382 cases.
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Modular flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal and proximal ureteral calculi: A single-surgeon experience of 382 cases.

机译：模块化柔性输尿管镜和激光碎石术治疗肾脏和近端输尿管结石：单手术经验382例。

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摘要

To determine the safety and efficacy of modular flexible ureteroscopy and holmium laser lithotripsy for the treatment of renal and proximal ureteral calculi, a retrospective chart review of a single surgeon's 3-year modular flexible ureteroscopy experience was performed. All of the patients were treated with modular flexible ureteroscopy and holmium laser lithotripsy by a single surgeon. Stone-free status was defined as no fragments or a single fragment ≤4 mm in diameter at the 3-month follow-up. The procedure number, operative time, stone-free rates, repeat usage of the multilumen catheter, and perioperative complications were documented. The present study included 215 male patients and 167 female patients, with an average age of 48.5±13.7 years (range, 17-84 years). The mean stone size was 11.5±4.1 mm (range, 4-28 mm), and the mean total stone burden was 17.5±5.7 mm (range 15-46 mm). A total of 305 patients (79.8%) had a stone burden ≤20 mm, and 77 patients (20.2%) had a stone burden >20 mm. The mean number of primary procedures was 1.3±0.2 (range, 1-3). The stone-free rate following the first and the second procedure was 73.4 and 86.9%, respectively. The mean postoperative hospital stay was 3.1±1.2 days (range, 2-6 days). The highest clearance rates were observed for proximal ureteral stones (100%) and renal pelvic stones (88.7%), whereas the lowest clearance rates were observed for lower calyx stones (76.7%) and multiple calyx stones (77.8%). The higher the initial stone burden, the lower the postoperative stone-free rate (≤20 vs. >20 mm; 89.8 vs. 75.3%). The overall complication rate was 8.1%. The results of the present study suggest that modular flexible ureteroscopy with holmium laser lithotripsy may be considered the primary method for the treatment of renal and proximal ureteral calculi in select patients, due to its acceptable efficacy, low morbidity, and relatively low maintenance costs.
机译：为了确定模块化输尿管镜和and激光碎石术治疗肾脏和近端输尿管结石的安全性和有效性，对一名外科医生三年的模块化输尿管镜检查经验进行了回顾性回顾。所有患者均由一名外科医生采用模块化柔性输尿管镜和and激光碎石术治疗。无结石状态定义为在三个月的随访中无碎片或直径≤4mm的单个碎片。记录手术次数，手术时间，无结石率，重复使用多腔导管和围手术期并发症。本研究包括215例男性患者和167例女性患者，平均年龄为48.5±13.7岁（范围17-84岁）。平均结石大小为11.5±4.1毫米（范围为4-28毫米），平均总结石负担为17.5±5.7毫米（范围为15-46毫米）。共有305例患者（79.8％）的石块负荷≤20mm，77例患者（20.2％）的石块负荷> 20 mm。初次手术的平均次数为1.3±0.2（范围1-3）。第一步和第二步的无结石率分别为73.4％和86.9％。术后平均住院时间为3.1±1.2天（范围为2-6天）。输尿管近端结石（100％）和肾盂结石（88.7％）的清除率最高，而较低的萼片结石（76.7％）和多个萼片结石的清除率最低（77.8％）。初始结石负担越高，术后无结石率越低（≤20vs.> 20 mm; 89.8 vs. 75.3％）。总体并发症发生率为8.1％。本研究的结果表明，具有flexible激光碎石术的模块化柔性输尿管镜由于其可接受的疗效，较低的发病率和相对较低的维护成本，可能被认为是治疗部分患者的肾脏和近端输尿管结石的主要方法。

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