Department of Urology; The First Affiliated Hospital (Jiangsu Province Hospital of TCM), Nanjing University of Chinese Medicine, Nanjing, 210046, Jiangsu, China.
World J Urol. 2013 Dec;31(6):1605-10. doi: 10.1007/s00345-013-1026-2. Epub 2013 Jan 20.
To provide appropriate evidence for treatment planning of patients with an impacted proximal ureteral stones ≥1.5 cm in size, by analyzing the therapeutic outcomes for those undergoing minimally invasive percutaneous antegrade ureterolithotripsy and retrograde ureterolithotripsy.
From September 2010 to November 2011, eligible patients with impacted proximal ureteral stones ≥1.5 cm in size referred to our institute were considered for this study. The closed envelope method was used to randomize the enrolled patients to mini-PCNL (30) or retrograde ureterolithotripsy (29). The efficiency quotient (EQ) was calculated to specifically address the efficiency for both the techniques. All preoperative and postoperative data for both groups were recorded.
The initial stone-free rate was 93.3% in the mini-PCNL group and 41.4% in the URSL group (p < 0.001). However, the overall stone-free rate at the 1-month follow-up visit after initial treatment was 100% in the mini-PCNL group and 89.7% in the URSL group (p = 0.07). The EQs for the mini-PCNL and URSL groups were 0.83 and 0.50, respectively.
Our study shows that mini-PCNL removal of large impacted proximal ureteral calculi can achieve higher stone-free rates and safe.
通过分析微创经皮顺行输尿管镜碎石术与逆行输尿管镜碎石术治疗嵌顿性近端输尿管结石≥1.5cm 的疗效，为此类患者的治疗方案提供合理的依据。
本研究纳入 2010 年 9 月至 2011 年 11 月期间我院收治的符合要求的嵌顿性近端输尿管结石≥1.5cm 的患者。采用信封法将纳入患者随机分为微创经皮顺行输尿管镜碎石术（30 例）或逆行输尿管镜碎石术（29 例）组。采用效率指数（EQ）专门评估两种技术的效率。记录两组所有术前和术后数据。
微创经皮顺行输尿管镜碎石术组的初始结石清除率为 93.3%，逆行输尿管镜碎石术组为 41.4%（p<0.001）。然而，初始治疗后 1 个月随访时，微创经皮顺行输尿管镜碎石术组的总体结石清除率为 100%，逆行输尿管镜碎石术组为 89.7%（p=0.07）。微创经皮顺行输尿管镜碎石术和逆行输尿管镜碎石术的 EQ 值分别为 0.83 和 0.50。
本研究表明，微创经皮顺行输尿管镜碎石术治疗大的嵌顿性近端输尿管结石可获得更高的结石清除率和安全性。
