Legemate Jaap D, Marchant Fernando, Bouzouita Abderrazak, Li Shengwen, McIlhenny Craig, Miller Nicole L, Saita Alberto, de la Rosette Jean J
Department of Urology, AMC University Hospital, Amsterdam, the Netherlands.
Department of Urology, Hospital Clínico Universidad de Chile, Santiago, Chile.
J Endourol. 2017 Oct;31(10):992-1000. doi: 10.1089/end.2017.0180. Epub 2017 Sep 20.
To determine the stone-free rates and intra- and postoperative complication rates and grades of ureterorenoscopic stone treatment in patients with a solitary kidney. This study is a subanalysis of the Clinical Research Office of the Endourological Society (CROES) ureterorenoscopy (URS) study, which is a prospective international multicenter observational study. Over a 1-year period, consecutive patients treated with ureterorenoscopy for urinary stones were included. Patients entered in this analysis were those with a solitary functioning kidney. Descriptive data on patient characteristics, stone-free rates, complication rates, and grades were evaluated for three separate groups: patients treated with ureteroscopy for ureteral stones, for renal stones, and a combination of renal and ureteral stones. A total of 301 patients were treated for stones in a solitary kidney; 219 were treated for ureteral stones. In this group, the stone-free rate was 88.6%, with an intraoperative complication rate of 7.4% and postoperative complication rate of 4.1%. Totally, 57 patients were treated for renal stones. In this group, the stone-free rate was 56.4%, with an intraoperative complication rate of 7.0% and postoperative complication rate of 10.5%. There were 25 patients who were treated for renal stones in combination with ureter stones. In this group, the stone-free rate was 60.0%, with an intraoperative complication rate of 12.0% and postoperative complication rate of 10.5%. Within the three groups, 72% of the postoperative complications were classified as Clavien I and II. Ureteroscopy is an effective and safe treatment modality for the removal of ureteral and renal stones in patients with a solitary kidney. Stone location as well as total stone burden seems to be important factors influencing the ability to render patients stone free. Moreover, single session ureteroscopic stone removal was less effective for the treatment of larger renal stones or renal stones in combination with ureteral stones.
确定单肾患者输尿管镜取石术的无石率、术中和术后并发症发生率及分级。本研究是腔内泌尿外科协会临床研究办公室（CROES）输尿管镜检查（URS）研究的一项亚分析，该研究是一项前瞻性国际多中心观察性研究。在1年期间，纳入了连续接受输尿管镜检查治疗尿路结石的患者。纳入本分析的患者为单功能肾患者。对三个不同组的患者特征、无石率、并发症发生率和分级的描述性数据进行了评估：接受输尿管镜检查治疗输尿管结石、肾结石以及肾和输尿管结石联合治疗的患者。共有301例单肾患者接受了结石治疗；219例接受了输尿管结石治疗。在该组中，无石率为88.6%，术中并发症发生率为7.4%，术后并发症发生率为4.1%。共有57例患者接受了肾结石治疗。在该组中，无石率为56.4%，术中并发症发生率为7.0%，术后并发症发生率为10.5%。有25例患者接受了肾结石合并输尿管结石的治疗。在该组中，无石率为60.0%，术中并发症发生率为12.0%，术后并发症发生率为10.5%。在这三组中，72%的术后并发症被分类为Clavien I级和II级。输尿管镜检查是治疗单肾患者输尿管和肾结石的一种有效且安全的治疗方式。结石位置以及结石总负荷似乎是影响患者无石状态的重要因素。此外，单次输尿管镜取石术对较大肾结石或肾结石合并输尿管结石的治疗效果较差。
