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单次输尿管镜下气压弹道碎石术治疗双侧输尿管结石。

Single-session ureteroscopic pneumatic lithotripsy for the management of bilateral ureteric stones.

机构信息

Department of Urology, Ministry of Health, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.

出版信息

Int Braz J Urol. 2012 Jan-Feb;38(1):63-8. doi: 10.1590/s1677-55382012000100009.

Abstract

PURPOSE

In nowadays there is no consensus on single-session ureteroscopic lithotripsy (URSL) for the management of bilateral ureteric stones. The aim of this study was to evaluate efficacy and safety of single-session URSL in patients with bilateral ureteric stones.

MATERIALS AND METHODS

41 patients who have undergone bilateral single-session URSL were evaluted in this study. A 8/9.8 Fr Wolf semi-rigid ureteroscope was used for the procedures, and the stones were fragmented with pneumatic lithotripter.

RESULTS

A high stone-free rate was achieved (90.2%) after single endoscopic procedure with a retreatment rate of 9.8%. The procedure was most successful for distal ureteric stones with a 96.2% stone-free rate followed by middle ureteric stones with a 81.8% stone-free rate while the least success was achieved for proximal ureteric stones with a 77.7% stone-free rate (p < 0.05). A greater stone-free rate was obtained in those with stones less than 10 mm (93.7%) than in those with stones larger than 10 mm (77.7%) (p < 0.05). Ureteral perforation occurred in only one patient (2.4%). No long-term complication was observed in any patient.

CONCLUSIONS

Bilateral single-session URSL can be performed effectively and safely with a low complication rate in patients with bilateral ureteric stones. It can reduce the need of anaesthetics and hospital stay.

摘要

目的

目前对于双侧输尿管结石的处理,单次输尿管镜碎石术(URSL)尚未达成共识。本研究旨在评估单次双侧输尿管镜碎石术治疗双侧输尿管结石的疗效和安全性。

材料和方法

本研究共评估了 41 例接受双侧单次 URSL 的患者。手术采用 8/9.8Fr Wolf 半刚性输尿管镜,使用气压弹道碎石器粉碎结石。

结果

单次内镜手术后结石清除率高(90.2%),再治疗率为 9.8%。对于下段输尿管结石,其结石清除率最高(96.2%),其次是中段输尿管结石(81.8%),而上段输尿管结石的结石清除率最低(77.7%)(p<0.05)。结石小于 10mm 的患者的结石清除率(93.7%)显著高于结石大于 10mm 的患者(77.7%)(p<0.05)。仅 1 例(2.4%)患者发生输尿管穿孔。无患者出现长期并发症。

结论

双侧单次 URSL 可有效、安全地治疗双侧输尿管结石,并发症发生率低,可减少麻醉和住院的需求。

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