逆行输尿管镜治疗输尿管下段结石:回顾性分析结果和并发症。

Retrograde ureteroscopy in the management of distal ureteric stones: A retrospective analysis of outcome and complications.

机构信息

Department of Surgery, Division of Urology, Jos University Teaching Hospital, Jos, Nigeria.

出版信息

Ann Afr Med. 2020 Oct-Dec;19(4):258-262. doi: 10.4103/aam.aam_65_19.

DOI:10.4103/aam.aam_65_19

PMID:33243949

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8015960/

Abstract

BACKGROUND

Urinary stones affect 8%-15% of the world population. In Nigeria, contemporary reports have shown that the incidence of urinary stones is rising. The distal ureter has been described as the most common location of ureteric stones. This study seeks to review our experience in the ureteroscopic management of distal ureteric stones with a view to appraising the stone clearance rate and the complications seen in our patients.

PATIENTS AND METHODS

This descriptive study reviewed the record of 21 patients, who had semirigid ureteroscopy and pneumatic lithotripsy for distal ureteric stone between October 2015 and September 2018. All patients had computed tomography urography preoperatively to locate the stone. Data on patients' demographics, indication for the surgery, location and size of stone, preoperative double-J (DJ) placement, postoperative DJ stent placement, intraoperative and postoperative complications, and status of stone clearance were retrieved and subjected to statistical analysis.

RESULTS

The mean age of the patients was 37.95 ± 11.09 (range, 21-67) years. The mean stone size was 8.06 ± 2.87 mm with a range of 4.8 mm-15.0 mm. Out of the 21 patients, 20 (95.2%) had the procedure for recurrent ureteric colic and 1 (48%) was for hematuria. Four (19.0%) patients had DJ stent preoperatively, whereas 17 (81.0%) patients did not have. Fourteen (66.7%) patients had intraoperative ureteric dilatation. Postoperative DJ stent was placed in 17 (81.0%) patients, whereas 4 (19.0%) patients did not have. Three (14.3%) patients had mucosal flap, 6 (14.3%) had mucosal abrasion, 2 (9.5%) had bleeding, 1 (4.8%) patient had transient hematuria postoperatively, and 2 (9.5%) patients had urinary tract infection. Nineteen (90.5%) patients had complete clearance in a single surgery. Two (9.5%) patients had symptomatic residual fragments that required repeat ureteroscopy.

CONCLUSION

Our study has shown that ureteroscopy is a useful and safe technique in the removal of stones in distal ureter.

摘要

背景

尿路结石影响全球 8%-15%的人口。在尼日利亚，当代报告显示尿路结石的发病率正在上升。输尿管的远段已被描述为输尿管结石最常见的部位。本研究旨在回顾我们在输尿管镜治疗输尿管远段结石方面的经验，评估结石清除率和患者的并发症。

患者和方法

这是一项描述性研究，回顾了 2015 年 10 月至 2018 年 9 月期间 21 例接受半刚性输尿管镜检查和气压弹道碎石术治疗输尿管远段结石的患者。所有患者均行术前 CT 尿路造影以定位结石。收集患者的人口统计学资料、手术指征、结石位置和大小、术前双 J 管（DJ）放置、术后 DJ 支架放置、术中及术后并发症以及结石清除情况，并进行统计学分析。

结果

患者的平均年龄为 37.95 ± 11.09（范围，21-67）岁。平均结石大小为 8.06 ± 2.87mm，范围为 4.8-15.0mm。21 例患者中，20 例（95.2%）因反复发作的输尿管绞痛而行该手术，1 例（48%）因血尿而行该手术。4 例（19.0%）患者术前放置 DJ 支架，17 例（81.0%）患者未放置。14 例（66.7%）患者行术中输尿管扩张。17 例（81.0%）患者术后放置 DJ 支架，4 例（19.0%）患者未放置。3 例（14.3%）患者出现黏膜瓣，6 例（14.3%）患者出现黏膜擦伤，2 例（9.5%）患者出现出血，1 例（4.8%）患者术后出现短暂性血尿，2 例（9.5%）患者发生尿路感染。19 例（90.5%）患者单次手术结石完全清除。2 例（9.5%）患者有症状性残余结石碎片，需再次行输尿管镜检查。