Rodrigues Netto N, Caserta Lemos G, Levi D'Ancona C A, Ikari O, Ferreira U, Francisco de Almeida Claro J
Hospital Israelita Albert Einstein, University of Campinas Medical Center, São Paulo, Brazil.
Eur Urol. 1990;17(4):269-72. doi: 10.1159/000464057.
The results of transurethral ureteroscopic stone removal in 144 patients were reviewed. Patients were treated by two different techniques according to the dilation of the ureterovesical junction before the introduction of the ureteroscope. Group 1 was represented by 71 patients submitted to ureteral dilation and in group 2 there were 73 patients treated without ureteral dilation. There was only one failure in introducing the instrument without ureteral dilation. In patients submitted to transurethral ureteroscopy with previous ureteral dilation, the success of ureteroscopic stone removal was 91.6% and complications occurred in 6.9%, and, in the cases not submitted to ureteral dilation, the success rate was 99.4% and the complication rate 4.1%. The success rate achieved in removing upper third stones was 100.0% middle third 90.5% and lower third stones 95.6%. Of the 144 patients treated, 8 (5.5%) had ureteral injury, but only 1 (0.6%) needed open surgery. We do not believe that ureteral dilation prevents complications or improves the results of ureteroscopic lithotripsy.
回顾了144例经尿道输尿管镜取石术的结果。根据输尿管镜插入前输尿管膀胱连接部的扩张情况，患者采用两种不同的技术进行治疗。第1组有71例患者接受了输尿管扩张，第2组有73例患者未进行输尿管扩张。未进行输尿管扩张时插入器械仅出现1例失败。在先前接受输尿管扩张的经尿道输尿管镜检查患者中，输尿管镜取石术的成功率为91.6%，并发症发生率为6.9%；在未接受输尿管扩张的病例中，成功率为99.4%，并发症发生率为4.1%。上1/3段结石的清除成功率为100.0%，中1/3段为90.5%，下1/3段结石为95.6%。在接受治疗的144例患者中，8例（5.5%）发生输尿管损伤，但仅1例（0.6%）需要开放手术。我们认为输尿管扩张并不能预防并发症或改善输尿管镜碎石术的结果。
