Tanaka M, Yamaguchi K, Takeuchi T, Nishimura Y, Tominaga T
Department of Urology, Mitsui Memorial Hospital.
Hinyokika Kiyo. 1998 Dec;44(12):857-60.
Between September 1993 and December 1996, 138 patients underwent transurethral ureterolithotripsy (TUL) either as primary treatment or as a second-line therapy after extracorporeal shock wave lithotripsy. In all patients, a semirigid 6.0 F ureteroscope was used. Lithotripsy was performed using a pulsed-dye laser. The overall success rate was 82.6%. The success rates according to the location of stones were as follows, 76.9% for stones in the upper ureter (U1), 96.0% for those in the midureter (U2), and 86.2% for those in the distal ureter (U3). In 68 patients treated with TUL as primary therapy, the success rate was 88.2% and efficiency quotient, which was modified for TUL was 0.75. Complications were rare: no ureteral perforations and no major bleeding occurred, but urosepsis developed in 2 patients. In conclusion, transurethral ureterolithotripsy using a small caliber ureteroscope with pulsed-dye laser is recommended as the primary treatment for mid- and distal ureteral stones, because of its superior success rate. In addition, for upper ureteral stones, laser tripsy is recommended as a helpful auxiliary procedure.
1993年9月至1996年12月期间，138例患者接受了经尿道输尿管碎石术（TUL），作为主要治疗方法或体外冲击波碎石术后的二线治疗。所有患者均使用半硬性6.0F输尿管镜。使用脉冲染料激光进行碎石术。总体成功率为82.6%。根据结石位置的成功率如下：上段输尿管结石（U1）为76.9%，中段输尿管结石（U2）为96.0%，下段输尿管结石（U3）为86.2%。在68例接受TUL作为主要治疗的患者中，成功率为88.2%，针对TUL调整后的效率商为0.75。并发症罕见：未发生输尿管穿孔和大出血，但有2例患者发生了尿脓毒症。总之，由于成功率较高，建议使用小口径输尿管镜结合脉冲染料激光的经尿道输尿管碎石术作为中段和下段输尿管结石的主要治疗方法。此外，对于上段输尿管结石，建议将激光碎石术作为一种有效的辅助手术。
