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一期双侧硬性输尿管镜检查

[One-stage bilateral rigid ureteroscopy].

作者信息

Hamida W, Hidoussi A, Jaidane M, Slama A, Youssef A, Sorba N B, Mosbah A T F

机构信息

Service d'urologie, CHU Sahloul, 4054 Sousse, Tunisie.

出版信息

Prog Urol. 2008 Oct;18(9):580-5. doi: 10.1016/j.purol.2008.06.005. Epub 2008 Jul 26.

Abstract

OBJECTIVE

To evaluate the results of one-stage bilateral rigid ureteroscopy for the treatment of bilateral ureteric stones and to identify predictive factors of failure.

MATERIALS AND METHODS

From January 1995 to June 2006, 61 patients were hospitalised for bilateral ureteric stones. Fifty patients, that is, 100 renal units were treated by first-line one-stage bilateral rigid ureteroscopy using an 8 F rigid ureteroscope and a ballistic lithotriptor. A complete statistical analysis (bivariate analysis completed by multivariate analysis) was performed to identify predictive factors of intraoperative failure.

RESULTS

The overall success rate per patient (success on at least one side) was 92% (with bilateral success in 70% of cases). Statistical analysis revealed a statistically significant difference between the two failure/success groups for mean stone diameter (p < 0.1%), site (p = 0.6%) and degree of cavity dilatation (p = 4%). Similarly, a strong statistical correlation was observed between these variables and intraoperative failure. The intraoperative complication rate was 4% (two patients) and the postoperative complication rate was 16%, corresponding to minor complications in every case (low back pain, fever) not requiring a supplementary procedure.

CONCLUSION

One-stage bilateral rigid ureteroscopy achieved satisfactory results similar to those of unilateral ureteroscopy. Predictive factors of failure were: stone diameter (greater than 15 mm), stones in the lumbar ureter and marked cavity dilatation.

摘要

目的

评估一期双侧硬性输尿管镜治疗双侧输尿管结石的效果,并确定失败的预测因素。

材料与方法

1995年1月至2006年6月,61例双侧输尿管结石患者入院治疗。其中50例患者,即100个肾单位,采用8F硬性输尿管镜和弹道碎石器进行一线一期双侧硬性输尿管镜治疗。进行了完整的统计分析(通过多变量分析完成双变量分析)以确定术中失败的预测因素。

结果

每位患者的总体成功率(至少一侧成功)为92%(70%的病例双侧成功)。统计分析显示,结石平均直径(p<0.1%)、结石部位(p=0.6%)和肾盂扩张程度(p=4%)在两个失败/成功组之间存在统计学显著差异。同样,这些变量与术中失败之间存在很强的统计相关性。术中并发症发生率为4%(2例患者),术后并发症发生率为16%,均为轻微并发症(腰痛、发热),无需额外手术。

结论

一期双侧硬性输尿管镜取得了与单侧输尿管镜相似的满意效果。失败的预测因素为:结石直径(大于15mm)、输尿管上段结石和明显的肾盂扩张。

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