Al-Qahtani Saeed M, Gil-Deiz-de-Medina Sixtina, Traxer Olivier
Department of Urology, Tenon University Hospital, Pierre and Marie Curie University, 4 rue de la Chine, 75020 Paris, France.
Adv Urol. 2012;2012:543537. doi: 10.1155/2012/543537. Epub 2011 Jun 9.
Objective. To evaluate the clinical outcome of flexible ureterorenoscopy (F-URS) with holmium laser in managing renal stone greater than 2 cm. Patients and Methods. Records of 120 patients (123 renal units) with renal stone greater than 2 cm who underwent F-URS with holmium laser iwere evaluated. The mean stone size was 26.3 mm. Patient and stone characteristics, perioperative outcomes and complications were evaluated. The outcome was determined at 4 weeks on plain radiograph (KUB) and Non-contrast CT scan (NCCT). Follow-up visit was up to 6 months to evaluate the clinical outcome and patients symptoms. Results. Stone burden was an independent predictor of FURS results. After first session of treatment, success rate was obtained in 72 renal units (58.5%). On the other hand, significant residual fragment was encountered in 51 renal units (41.5%). This was improved with "staged-therapy" to 87% and 96.7% after second and third session of treatment, respectively. Complications were recorded. They were managed in proper manner accordingly. Conclusion. This is an attractive, safe and effective technique. It is an ideal option for low volume complex stone with average burdens of 2 to 3 cm. Patient should be informed and consented about staged-therapy.
目的。评估钬激光软性输尿管肾镜检查（F-URS）治疗直径大于2厘米肾结石的临床疗效。患者与方法。对120例（123个肾单位）接受钬激光F-URS治疗的直径大于2厘米肾结石患者的记录进行评估。结石平均大小为26.3毫米。评估患者和结石特征、围手术期结果及并发症。在4周时通过腹部平片（KUB）和非增强CT扫描（NCCT）确定治疗结果。随访长达6个月以评估临床疗效和患者症状。结果。结石负荷是FURS结果的独立预测因素。首次治疗后，72个肾单位（58.5%）获得成功。另一方面，51个肾单位（41.5%）出现明显残留碎片。通过“分期治疗”，第二次和第三次治疗后分别改善至87%和96.7%。记录了并发症情况，并相应地进行了妥善处理。结论。这是一种有吸引力、安全且有效的技术。对于平均负荷为2至3厘米的少量复杂结石，它是理想的选择。应告知患者并征得其对分期治疗的同意。
