Xu Ke, Ding Jie, Shi Bowen, Wu Yanyuan, Huang Yunteng
Department of Urology, School of Medicine, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200092, P.R. China.
Exp Ther Med. 2018 Sep;16(3):1723-1728. doi: 10.3892/etm.2018.6369. Epub 2018 Jun 28.
The present study reported the clinical experience of using a PolyScope with holmium laser lithotripter in managing renal calculi in senile patients. Between December 2013 and December 2016, 157 senile patients (69.1±6.1 years old) were treated with PolyScope holmium laser lithotripsy for renal calculi at Xin Hua Hospital (Shanghai, China). The mean stone digitized surface area was 154.2±57.7 mm (range, 55.8-478.3 mm). A thorough medical history investigation, and laboratory and radiological examination were followed by proper preoperative management. The PolyScope was then passed into the renal cavities following the position of the ureteral access sheath, with laser energy maintained at 1.0-2.0 J, frequency 10-15 Hz. The demographical and operative information of senile patients were compared with that of the 332 non-senile patients operated at the same period time. The average operative time was 54.6±13.2 min (range, 37-124 min). No major complications, including ureteral perforation or sepsis were encountered. The single session stone-free rate (SFR) was 81.5% and the overall SFR was 89.2%, similar to that of the non-senile group. PolyScope combined with holmium laser lithotripter is safe and effective in managing renal calculi in senile patients compared with non-senile patients, with considerately high SFRs and low complication rates.
本研究报告了使用带有钬激光碎石器的输尿管软镜治疗老年患者肾结石的临床经验。2013年12月至2016年12月期间，157例老年患者（年龄69.1±6.1岁）在中国上海新华医院接受了输尿管软镜钬激光碎石术治疗肾结石。结石数字化表面积平均为154.2±57.7平方毫米（范围为55.8 - 478.3平方毫米）。在进行全面的病史调查、实验室及影像学检查后进行适当的术前处理。然后沿输尿管鞘位置将输尿管软镜插入肾盂，激光能量维持在1.0 - 2.0焦耳，频率为10 - 15赫兹。将老年患者的人口统计学和手术信息与同期接受手术的332例非老年患者进行比较。平均手术时间为54.6±13.2分钟（范围为37 - 124分钟）。未出现包括输尿管穿孔或脓毒症在内的严重并发症。单次手术结石清除率（SFR）为81.5%，总体SFR为89.2%，与非老年组相似。与非老年患者相比，输尿管软镜联合钬激光碎石器治疗老年患者肾结石安全有效，结石清除率高且并发症发生率低。
