Kaygısız Onur, Coşkun Burhan, Kılıçarslan Hakan, Kordan Yakup, Vuruşkan Hakan, Özmerdiven Gökhun, Yavaşcaoğlu İsmet
Urol Int. 2015;94(2):205-9. doi: 10.1159/000368374. Epub 2015 Jan 29.
To compare the effectiveness and complications of ureteroscopic laser lithotripsy with laparoscopic ureter laparoscopic ureterolithotomy in mid- or proximal portion of large ureteral stones.
We reviewed patients with large (>15 mm) ureteral stone and those who underwent ureteroscopic laser lithotripsy (URS group) or laparoscopic ureterolithotomy (LU group). The first attempt was considered successful in patients who had residual fragments smaller than 2 mm and no conversion of the primary procedure to another.
Sixty patients (URS group 29, LU group 31) met inclusion criteria. FURS was used as an adjunctive procedure in one patient for URS group and in two patients for LU group in the same season. LU had a higher success rate and the first-day stone-free rate when compared with URS. Number of procedures was also significantly higher in URS group. There was no difference in stone-free rates at the first and third months, and length of hospitalization and operation were higher in the LU group. Only two patients in the LU group and one patient in the URS group had major complications.
Laparoscopy is an effective option of large proximal and mid-ureter stone treatment; however, URS provides similar stone-free rates at three months as a minimal invasive procedure.
比较输尿管镜激光碎石术与腹腔镜输尿管切开取石术治疗输尿管中、上段大结石的疗效及并发症。
我们回顾性分析了患有大（>15mm）输尿管结石且接受输尿管镜激光碎石术（URS组）或腹腔镜输尿管切开取石术（LU组）的患者。首次尝试在残留碎片小于2mm且未将原手术转换为其他手术的患者中被视为成功。
60例患者（URS组29例，LU组31例）符合纳入标准。在同一季节，URS组有1例患者和LU组有2例患者将FURS用作辅助手术。与URS相比，LU的成功率和首日结石清除率更高。URS组的手术次数也明显更多。第1个月和第3个月的结石清除率无差异，LU组的住院时间和手术时间更长。LU组仅2例患者和URS组仅1例患者出现严重并发症。
腹腔镜手术是治疗输尿管上段和中段大结石的有效选择；然而，作为一种微创手术，URS在三个月时的结石清除率与之相似。
