Tiwari Kabir, Upadhaya Amit Mani, Kuwar Ashok, Shrestha Sanjesh Bhakta
Department of Surgery, Kathmandu Model Hospital, Phect, Nepal.
J Nepal Health Res Counc. 2019 Aug 4;17(2):233-237. doi: 10.33314/jnhrc.v0i0.1696.
Semi-rigid ureteroscopy lithotripsy have become standard of treatment for ureteral calculi. The aim of this study isto review outcome of Semi-rigidureteroscopy lithotripsy and to report the complications encountered.
After approval from institutional committee of Public Health Concern Trust Nepal,we retrospectively reviewed the chart of all patients of ureteral stone who underwent ureteroscopy and pneumatic lithotripsy at Kathmandu Model Hospital between January 2013 and September 2017. Patient characteristics, stone size, success rate and complications were assessed. Intraoperative complications were graded using modified Satava classification system and the postoperative complications graded according to modified Clavien classification system. The success rate was based on stone free status after primary semi-rigid ureteroscopy lithotripsy, without the need of any other secondary procedures.
Total 232 patients underwent semi-rigidureteroscopy lithotripsy. Mean age was 46 (16-76) years, with 128 males and 104 females. Size of the stone ranges from 5-18mm. The success rate of primary semi-rigidureteroscopy lithotripsy was in218 (93.9%) cases.Most intraoperative complications were modified Satava grade I (41.7%) andII(3.87%).Four(1.7%) patient had grade III complication, requiring conversion to open surgery. Ureteral avulsion was seen in 1(0.43%) patient, requiring ureteral reimplantation.The postoperative complication were modified Clavien grade I(10.7%), grade II(5.17%), grade III (4.6%) and grade IV(0.43%). Double J stents were inserted in all the patients postoperatively.The mean hospital stay was 2.2(1-14)days.
Semi-rigid ureteroscopy lithotripsy for the management of ureteral stones is efficacious and have a lesser major complications.
半硬性输尿管镜碎石术已成为输尿管结石的标准治疗方法。本研究的目的是回顾半硬性输尿管镜碎石术的治疗结果并报告所遇到的并发症。
在获得尼泊尔公共卫生关注信托机构委员会的批准后，我们回顾性分析了2013年1月至2017年9月在加德满都模范医院接受输尿管镜检查和气压弹道碎石术的所有输尿管结石患者的病历。评估了患者特征、结石大小、成功率和并发症。术中并发症采用改良的萨塔瓦分类系统分级，术后并发症根据改良的克莱维恩分类系统分级。成功率基于初次半硬性输尿管镜碎石术后结石清除状态，无需任何其他二次手术。
共有232例患者接受了半硬性输尿管镜碎石术。平均年龄为46岁（16 - 76岁），其中男性128例，女性104例。结石大小范围为5 - 18毫米。初次半硬性输尿管镜碎石术的成功率为218例（93.9%）。大多数术中并发症为改良萨塔瓦I级（41.7%）和II级（3.87%）。4例（1.7%）患者出现III级并发症，需要转为开放手术。1例（0.43%）患者出现输尿管撕脱，需要进行输尿管再植术。术后并发症为改良克莱维恩I级（10.7%）、II级（5.17%）、III级（4.6%）和IV级（0.43%）。所有患者术后均插入了双J支架。平均住院时间为2.2天（1 - 14天）。
半硬性输尿管镜碎石术治疗输尿管结石有效，且主要并发症较少。
