Ben Saddik M A, Al-Qahtani Sejiny S, Ndoye M, Gil-Diez-de-Medina S, Merlet B, Thomas A, Haab F, Traxer O
Service d'urologie, CHU Tenon, université de Pierre-et-Marie-Curie, Paris VI, 4, rue de la Chine, 75970 Paris cedex, France.
Prog Urol. 2011 May;21(5):327-32. doi: 10.1016/j.purol.2010.07.012. Epub 2011 Mar 31.
Our aim was to evaluate the outcome of flexible ureteroscopy (F-URS) with Holmium Laser as a minimal invasive procedure for kidney stone between 2 and 3 cm in diameter.
We prospectively evaluated 101 patients (103 kidney units) with kidney stone between 2 and 3 cm, who underwent flexible ureteroscopy (F-URS) with Holmium Laser. Patient age, sex, body mass index (BMI), stone size, stone composition, associated lower calyx stone, prestenting, congenital abnormalities, urological history, operating time and complications were evaluated. The outcome was determined at 4 weeks on plain radiograph (KUB) and noncontrast CT scan (NCCT) or by endoscopic second look if needed. Ureteroscopy success rate was defined as stone free (SF) or remaining fragments (RF) less than 3 mm.
After F-URS session we obtained a stone free status in 35 kidney units (34%), residual fragment less than 3mm in 30 kidney units (29.1%) and 38 kidney units (36.9%) with significant residual fragment. F-URS success rate was 89.3% and 97.1% after second and third session, respectively.
F-URS with Holmium Laser is a very effective and safe technique in treating kidney stone. This technique should be proposed to patient with kidney stone between 2 and 3 cm as one of the treatment modalities, F-URS offers excellent results, low rate of complications and short hospital stay. Patients should be informed about staged therapy.
我们的目的是评估钬激光软性输尿管镜检查(F-URS)作为一种微创治疗方法对直径在2至3厘米之间肾结石的治疗效果。
我们前瞻性评估了101例(103个肾单位)直径在2至3厘米之间的肾结石患者,这些患者接受了钬激光软性输尿管镜检查(F-URS)。评估了患者的年龄、性别、体重指数(BMI)、结石大小、结石成分、合并的下盏结石、预先置入支架、先天性异常、泌尿系统病史、手术时间和并发症。在4周时通过腹部平片(KUB)和非增强CT扫描(NCCT)确定治疗效果,必要时通过内镜二次检查确定。输尿管镜检查成功率定义为结石清除(SF)或残留碎片(RF)小于3毫米。
F-URS手术后,35个肾单位(34%)达到结石清除状态,30个肾单位(29.1%)残留碎片小于3毫米,38个肾单位(36.9%)有明显残留碎片。第二次和第三次手术后F-URS成功率分别为89.3%和97.1%。
钬激光软性输尿管镜检查(F-URS)是治疗肾结石非常有效且安全的技术。对于直径在2至3厘米之间的肾结石患者,应将该技术作为治疗方式之一推荐给他们,F-URS效果良好、并发症发生率低且住院时间短。应告知患者分期治疗的情况。