Tao Wei, Ming Xu, Zang Yachen, Zhu Jin, Zhang Yuanyuan, Sun Chuanyang, Xue Boxin
Department of Urology, the Second Affiliated Hospital of Soochow University, Suzhou, China.
Institute for Regenerative Medicine, Wake Forest University, Winston-Salem, NC, USA.
J Xray Sci Technol. 2022;30(1):123-133. doi: 10.3233/XST-210992.
To evaluate efficacy and safety of flexible ureteroscopy and laser lithotripsy (FURSL) for treatment of the upper urinary tract calculi.
We retrospectively analyzed 784 patients who underwent FURSL between January 2015 and October 2020 in our unit. All patients were preoperatively evaluated with urine analysis, serum biochemistry, urinary ultrasonography, non-contrast computed tomography and intravenous urography. The procedure was considered as successful in patients with complete stone disappearance or fragments < 4 mm on B ultrasound or computed tomography. The operative parameters, postoperative outcomes and complications were recorded and analyzed respectively.
The average operative time and postoperative hospital stay were 46.9±15.8 min and 1.2±1.1 days, respectively, among 784 patients. In addition, 746 patients were followed up and 38 patients were lost. In these patients, 700 (93.8%) cases met the stone removal criteria and 46 cases (6.2%) did not meet the stone removal criteria who need further treatment. The stone free rate (SFR) is 92.5%after 1-3 months and SFR of middle and upper calyceal calculi was higher than that of lower calyceal calculi significantly. The most common complications were fever (58/784, 7.4%), gross hematuria (540/784, 68.9%) and lpsilateral low back pain (47/784, 6.0%). The incidence rate of serious complication was 1.28%(10/784), including 5 cases of septic shock and 5 cases of subcapsular hematoma, which were cured after active treatment.
FURSL is a reliable treatment for small and medium calculi patients of upper urinary tract. The curative effect of stone removal is clear. The complications are few and the safety is high. However, there are certain limitations to the efficacy in treating larger stone and lower calyceal calculi.
评估输尿管软镜激光碎石术（FURSL）治疗上尿路结石的疗效和安全性。
我们回顾性分析了2015年1月至2020年10月在我院接受FURSL治疗的784例患者。所有患者术前均进行了尿液分析、血清生化、泌尿系统超声、非增强计算机断层扫描和静脉肾盂造影检查。若患者结石完全消失或在B超或计算机断层扫描上结石碎片<4mm，则该手术被视为成功。分别记录并分析手术参数、术后结果及并发症。
784例患者的平均手术时间和术后住院时间分别为46.9±15.8分钟和1.2±1.1天。此外，746例患者得到随访，38例失访。在这些患者中，700例（93.8%）达到结石清除标准，46例（6.2%）未达到结石清除标准，需要进一步治疗。1 - 3个月后的结石清除率（SFR）为92.5%，中、上盏结石的SFR显著高于下盏结石。最常见的并发症为发热（58/784，7.4%）、肉眼血尿（540/784，68.9%）和患侧腰痛（47/784，6.0%）。严重并发症发生率为1.28%（10/784），包括5例感染性休克和
