Mulţescu R, Geavlete B, Georgescu D, Geavlete P, Chiuţu L
Chirurgia (Bucur). 2014 Jan-Feb;109(1):95-8.
Pyelocaliceal calculi flexible ureteroscopic approach raises problems related to operative time, associated morbidity and costs, especially by potential endoscope damage.
5 series, each of 20 patients with single pyelocaliceal lithiasis, were analyzed: Group I with calculi 1 cm fragmented to dust, Group II with calculi 1 cm with lithotripsy in fragments, Group III with calculi of 1-2 cm fragmented to dust, Group IV with calculi of 1-2 cm with lithotripsy in fragments, Group V with calculi of 1-2 cm fragmented to dust until they reached 1 cm, and lithotripsy in fragments afterwards. In all cases Ho:YAG lithotripsy was used.
Ureteral access sheath was used in 70% of the cases. Mean operating time was 39 min in group I, 21 min in Group II, 112 min in group III, 72 min in group IV and 51 min in group V. Minor complications occurred in 7 cases,while a single major complication occurred in group IV.
The optimal lithotripsy method for calculi 1cm seems to be in extractable fragments. Larger calculi should be fragmented to dust until they reach 1 cm and then the lithotripsy should be continued into extractable fragments.
Ho: YAG - Holmium: Yttrium Aluminium Garnet, Hz - Hertz, mJ - milli joule.
肾盂肾盏结石的软性输尿管镜治疗方法存在手术时间、相关发病率和成本等方面的问题，尤其是可能会对内窥镜造成损害。
分析了5组病例，每组20例单一肾盂肾盏结石患者：第一组结石为1厘米，粉碎成粉末；第二组结石为1厘米，碎石成碎片；第三组结石为1 - 2厘米，粉碎成粉末；第四组结石为1 - 2厘米，碎石成碎片；第五组结石为1 - 2厘米，先粉碎成粉末直至结石直径达1厘米，之后再碎石成碎片。所有病例均采用钬激光碎石术。
70%的病例使用了输尿管通路鞘。第一组平均手术时间为39分钟，第二组为21分钟，第三组为112分钟，第四组为72分钟，第五组为51分钟。7例出现轻微并发症，第四组出现1例严重并发症。
对于1厘米的结石，最佳的碎石方法似乎是将其碎成可取出的碎片。较大的结石应先粉碎成粉末直至直径达1厘米，然后继续将其碎成可取出的碎片。
Ho:YAG - 钬:钇铝石榴石，Hz - 赫兹，mJ - 毫焦
