Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.
J Endourol. 2011 Mar;25(3):431-5. doi: 10.1089/end.2010.0233.
To assess effectiveness of flexible ureteroscopy (fURS) in patients not with simple but with multiple unilateral renal stones.
A database analysis was performed to identify patients with multiple unilateral intrarenal stones. Patients were treated using an 8.8F flexible ureteroscope. Patients were considered stone free if no residual stones were seen endoscopically and radiographically after the procedure. The efficiency and the safety of the procedures were analyzed.
Between 2006 and 2008, 1054 ureteroscopic procedures were performed in our department; 125 patients met the inclusion criteria. Holmium:yttrium-aluminum-garnet laser lithotripsy was necessary in 41 (32.8%) patients. The mean stone size was 11.93 ± 8.2 mm, with a mean stone burden of 83.7 ± 67.66 mm(2). The mean number of stones was 3.59 ± 3.57. Twenty-six (20.8%) patients had a stone burden ≥ 100 mm(2), and 99 (79.2%) a stone burden <100 mm(2). The overall stone-free rate after a single procedure of fURS was 74.4%. In the remaining 32 patients with residual stones, the mean stone burden dropped from 123.24 ± 84.36 mm(2) to 56.28 ± 52.53 mm(2). The stone-free rate in patients with a stone burden ≥ 100 mm(2) was 65.4% and 79.5% in patients with a stone burden < 100 mm(2), respectively. Complications have been recorded in seven (5.6%) patients, including urinary tract infection in four, ureteral perforation in one, and hematuria in two patients. No major complications occurred. All patients were treated conservatively.
fURS is an effective treatment option in patients with multiple unilateral renal stones. Single procedure stone-free rates are high with a low rate of only minor complications.
评估在不单纯但有多枚单侧肾结石的患者中使用软性输尿管镜（fURS）的疗效。
对数据库进行分析以确定有多枚单侧肾内结石的患者。使用 8.8F 软性输尿管镜进行治疗。如果在手术后内窥镜和影像学检查没有发现残留结石，则认为患者结石清除。分析了手术的效率和安全性。
2006 年至 2008 年，我院共进行了 1054 例输尿管镜检查，其中 125 例符合纳入标准。41 例（32.8%）患者需要行钬激光碎石术。结石平均大小为 11.93 ± 8.2mm，平均结石负荷为 83.7 ± 67.66mm²。结石平均数量为 3.59 ± 3.57。26 例（20.8%）患者结石负荷≥100mm²，99 例（79.2%）患者结石负荷<100mm²。单次 fURS 后的总体结石清除率为 74.4%。在其余 32 例有残留结石的患者中，平均结石负荷从 123.24 ± 84.36mm²降至 56.28 ± 52.53mm²。结石负荷≥100mm²的患者结石清除率为 65.4%，结石负荷<100mm²的患者结石清除率为 79.5%。记录了 7 例（5.6%）患者的并发症，包括 4 例尿路感染、1 例输尿管穿孔和 2 例血尿。没有发生严重并发症。所有患者均接受保守治疗。
fURS 是治疗多枚单侧肾结石的有效方法。单次手术结石清除率高，仅有少数轻微并发症。
