Barbier E, Statoua M, Mazdar A, Hollard D, Houndete F, Hubert J
Service d'urologie, centre hospitalier de Lunéville, 2, rue Level, 54301 Luneville, France; Service d'urologie, hôpitaux de Brabois, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.
Service d'urologie, centre hospitalier de Lunéville, 2, rue Level, 54301 Luneville, France.
Prog Urol. 2015 May;25(6):336-41. doi: 10.1016/j.purol.2015.02.001. Epub 2015 Mar 6.
During the last decade, the advent of flexible ureteroscopy with laser lithotripsy has revolutionized the management of upper urinary tract stones. Our center is a primary care hospital that is equipped with this technology since January 2011. This study reported our initial experience of first 225 cases.
This study is a descriptive, retrospective and monocentric analysis. The first 225 cases, operated consecutively by 3 surgeons during 26 months, were analyzed. We have used 2 flexible ureteroscopes (1 digital, 1 optical). Laser source was an Holmium laser (Stonelight) at a power of 5 watts.
The mean age was 53 years (± 10.2) and the mean stones size was 11 mm (2.3). In 49% of cases, ureteroscopy was chosen for the first, without prior treatment. In 59% of cases, ureteroscopy was used after failure of other treatment (ESWL in 70% of cases). The mean operative time was 72 minutes (± 16.6) and the mean length of stay was 2.6 days (± 0.8). The first session of ureteroscopy was a success in 93% of cases without residual fragments after 1 month. The frequency of postoperative complications was estimated at 8% (Clavien I and II).
Flexible ureteroscopy with laser lithotripsy was a safe and effective technique, allowing the treatment of all upper urinary tract stones, especially on failure of other treatment. Its place in the first intention is widespread in our exercise, especially among obese patients, patients on anticoagulant therapy or with stone of the lower pole.
在过去十年中，可弯曲输尿管镜联合激光碎石术的出现彻底改变了上尿路结石的治疗方式。自2011年1月起，我们中心作为一家基层医疗医院就配备了这项技术。本研究报告了我们最初225例病例的经验。
本研究为描述性、回顾性单中心分析。分析了3位外科医生在26个月内连续进行手术的前225例病例。我们使用了2台可弯曲输尿管镜（1台数字式，1台光学式）。激光源为钬激光（Stonelight），功率为5瓦。
平均年龄为53岁（±10.2），平均结石大小为11毫米（2.3）。49%的病例首次选择输尿管镜检查，未进行过前期治疗。59%的病例在其他治疗失败后采用输尿管镜检查（70%的病例为体外冲击波碎石术失败）。平均手术时间为72分钟（±16.6），平均住院时间为2.6天（±0.8）。输尿管镜检查的首次手术在93%的病例中成功，1个月后无残留碎片。术后并发症发生率估计为8%（Clavien I和II级）。
可弯曲输尿管镜联合激光碎石术是一种安全有效的技术，可用于治疗所有上尿路结石，尤其是在其他治疗失败的情况下。在我们的实践中，其作为首选治疗方法的应用广泛，特别是在肥胖患者、接受抗凝治疗的患者或下极结石患者中。
