Zerbib M, Flam T, Belas M, Debre B, Steg A
Department of Urology, Hôpital Cochin, Paris, France.
J Clin Laser Med Surg. 1990 Dec;8(6):31-3. doi: 10.1089/clm.1990.8.31.
Forty-five patients with 46 ureteral stones were treated using a new pulsed dye laser (Pulsolith, TMI). A fiber of 250 micrometers was used through rigid (40 cases) or flexible (6 cases) ureteroscopes. Stones were located in the upper third (5 cases), middle third (5 cases), or lower third (36 cases) of the ureter. Stone composition was calcium oxalate dihydrate or monohydrate, struvite, or uric acid in 34, 7, 2, and 2 patients, respectively. Thirty-six stones (78%) were fragmented, including 14 cases that required basket removal of fragments at the same time. Ten stones were not fragmented, 6 because of the pure monohydrate composition and 4 due to a laser breakdown. No damage to the ureteral wall was noted. Retrograde rigid ureteroscopy with laser lithotripsy was effective for lower and middle third ureteral stones. Flexible ureteroscopy with laser lithotripsy was effective (impacted stones) but difficult for upper third ureteral stones. Laser lithotripsy was not effective for pure calcium oxalate monohydrate stones.
45例患有46枚输尿管结石的患者接受了一种新型脉冲染料激光（Pulsolith，TMI）治疗。通过硬性输尿管镜（40例）或软性输尿管镜（6例）使用250微米的光纤。结石位于输尿管上三分之一段（5例）、中三分之一段（5例）或下三分之一段（36例）。结石成分分别为二水合草酸钙或一水合草酸钙、磷酸镁铵或尿酸的患者有34例、7例、2例和2例。36枚结石（78%）被击碎，其中14例同时需要用网篮取出碎片。10枚结石未被击碎，6枚是因为纯一水合草酸钙成分，4枚是由于激光击穿。未发现输尿管壁受损。逆行硬性输尿管镜联合激光碎石术对输尿管中下段结石有效。软性输尿管镜联合激光碎石术对嵌顿结石有效，但对上段输尿管结石操作困难。激光碎石术对纯一水合草酸钙结石无效。
