Aghamir Seyed Kazem, Mohseni Mohammad Ghasem, Ardestani Arash
Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Hassan Abad Square, Hafez Street, Tehran, Iran.
J Endourol. 2003 Dec;17(10):887-90. doi: 10.1089/089277903772036208.
Ballistic lithotripsy is one of the new intracorporeal lithotripsy methods. In this study, the efficacy and complications of this method in the management of ureteral calculi were evaluated.
From November 1999 to December 2001, 340 patients (mean age 39.8 years; range 1.5-82 years) with a total of 362 ureteral calculi (bilateral in 22 cases) were treated with an 8.5F rigid ureteroscope and the Swiss Lithoclast. Of the calculi, 115 (32%) were located in the upper ureter, 63 (17%) in the middle ureter, and 184 (51%) in the lower ureter. The mean stone size was 10.4 mm (range 5-22 mm).
Nearly all (344; 95%) of the calculi were accessible with the ureteroscope, and 321 calculi (88.7%) were fragmented completely, either with no residual fragments or with residual fragments <3 mm. In 3 cases (0.8%), there were residual fragments of about 4 mm after the procedure that passed spontaneously. Twenty calculi (5.5%) migrated to the kidney during the procedure and were subsequently treated with adjuvant SWL. Major complications occurred in 2 cases (0.54%): ureteral perforation and stenosis in 1 patient each. The 2-week stone-free rate was 89.5% (324/362).
Lithoclast ballistic lithotripsy is a safe and effective approach for the treatment of ureteral calculi regardless of composition.
弹道碎石术是一种新型体内碎石方法。本研究评估了该方法治疗输尿管结石的疗效及并发症。
1999年11月至2001年12月，340例患者（平均年龄39.8岁；年龄范围1.5 - 82岁）共362枚输尿管结石（双侧结石22例）接受了8.5F硬性输尿管镜及瑞士碎石机治疗。其中，115枚结石（32%）位于输尿管上段，63枚（17%）位于输尿管中段，184枚（51%）位于输尿管下段。结石平均大小为10.4mm（范围5 - 22mm）。
几乎所有结石（344枚；95%）均可通过输尿管镜到达，321枚结石（88.7%）被完全击碎，无残留碎片或残留碎片<3mm。3例（0.8%）术后有残留约4mm的碎片，随后自行排出。20枚结石（5.5%）在手术过程中移行至肾脏，随后接受辅助体外冲击波碎石治疗。主要并发症发生2例（0.54%）：1例输尿管穿孔，1例输尿管狭窄。两周无石率为89.5%（324/362）。
无论结石成分如何，碎石机弹道碎石术都是治疗输尿管结石的一种安全有效的方法。
