Akdeniz Ekrem, İrkılata Lokman, Demirel Hüseyin Cihan, Saylık Acun, Bolat Mustafa Suat, Şahinkaya Necmettin, Zengin Mehmet, Atilla Mustafa Kemal
Department of Urology, Samsun Training and Research Hospital, Samsun, Turkey.
Turk J Urol. 2014 Sep;40(3):138-43. doi: 10.5152/tud.2014.46548.
We aimed to compare the effectiveness of holmium YAG laser and pneumatic lithotripsy in the treatment of ureteral stones.
A total of 216 patients who had established indications of ureteroscopy between November 2011 and June 2012 were included in this study. Patients' files were retrospectively reviewed by dividing cases as groups that underwent pneumatic (PL) or laser lithotripsy (LL) procedures. Age, sex, stone burden and localization, duration of follow-up, operative times were evaluated. Stone-free rates were evaluated by ureteroscopical examination, postoperative scout films and ultrasonography.
Group PL consisted of 109 and group LL of 107 patients. Median age was 43.93±15.94 years in Group PL and 46.15±14.54 years in Group LL. Male to female ratio, stone burden and localization were similar for both groups. Overall success rate was 89.9% in Group PL and 87.9% in Group LL, respectively (p<0.791). With the aid of additional procedures, success rate was 100% for both groups at the end of the first month. Groups were not different as for operative time, rate of insertion of an ureteral catheter and its removal time. Hospitalization period was apparently somewhat shorter in Group LL (p=0.00).
Pneumatic lithotripsy can be as efficacious as laser lithotripsy and be used safely in the endoscopic management of ureteral stone. In comparison of both methods, we detected no differences as to operative time, success of operation and the time to removal of the catheter, however, hospitalization period was shorter in Group LL.
我们旨在比较钬激光和气压弹道碎石术治疗输尿管结石的疗效。
本研究纳入了2011年11月至2012年6月间有输尿管镜检查明确指征的216例患者。通过将病例分为接受气压弹道（PL）或激光碎石术（LL）的组，对患者病历进行回顾性分析。评估患者的年龄、性别、结石负荷和位置、随访时间、手术时间。通过输尿管镜检查、术后定位片和超声检查评估结石清除率。
PL组109例患者，LL组107例患者。PL组中位年龄为43.93±15.94岁，LL组为46.15±14.54岁。两组的男女比例、结石负荷和位置相似。PL组总体成功率分别为89.9%，LL组为87.9%（p<0.791）。借助额外的操作，两组在第一个月末成功率均为100%。两组在手术时间、输尿管导管插入率及其拔除时间方面无差异。LL组住院时间明显较短（p=0.00）。
气压弹道碎石术在输尿管结石的内镜治疗中与激光碎石术疗效相当且使用安全。比较两种方法，我们发现在手术时间、手术成功率和导管拔除时间方面没有差异，然而，LL组住院时间较短。
