Johnston Maximilian J, Sinha Mriganka, Pietropaolo Amelia, Somani Bhaskar K
Department of Urology, University Hospital of Southampton, Southampton, United Kingdom.
Department of Surgery and Cancer, Imperial College London, London, United Kingdom.
Cent European J Urol. 2022;75(4):405-408. doi: 10.5173/ceju.2022.185. Epub 2022 Nov 5.
Urinary tract calculi are commonly treated with ureteroscopy and laser stone fragmentation (URSL). The composition of calculi depends on underlying patient factors. Stones associated with metabolic or infectious conditions are sometimes thought to be more difficult to treat. This analysis explores whether the composition of calculi impacts on stone-free and complication rates.
A prospectively maintained database of patients undergoing URSL between 2012-2021 was used to explore records for patients with uric acid (Group A), infection (Group B) and calcium oxalate monohydrate (Group C) calculi. Patients who had undergone URSL to treat ureteric or renal calculi were included. Patient demographics, stone parameters and operative details were collected, with the principal outcomes being stone-free rate (SFR) and associated complications.
A total of 352 patients were included (58 Group A, 71 Group B and 223 Group C patients) and had their data analysed. SFR was >90% for all three groups and a single Clavien-Dindo grade III complication was noted. No significant differences were found between the groups for complications, SFR and day case rates.
This cohort of patients demonstrated that outcomes were similar for three different types of urinary tract calculi, which form for differing reasons. URSL appears to be an effective, safe treatment for all stone types with comparable results.
尿路结石通常采用输尿管镜检查和激光碎石术(URSL)进行治疗。结石的成分取决于患者的潜在因素。与代谢或感染性疾病相关的结石有时被认为更难治疗。本分析探讨结石成分是否会影响结石清除率和并发症发生率。
使用一个前瞻性维护的2012年至2021年间接受URSL治疗患者的数据库,以探究尿酸结石患者(A组)、感染性结石患者(B组)和一水草酸钙结石患者(C组)的记录。纳入接受URSL治疗输尿管或肾结石的患者。收集患者的人口统计学数据、结石参数和手术细节,主要结局为结石清除率(SFR)和相关并发症。
共纳入352例患者(A组58例、B组71例、C组223例)并对其数据进行分析。三组的结石清除率均>90%,且记录到1例Clavien-Dindo III级并发症。三组在并发症、结石清除率和日间手术率方面未发现显著差异。
该队列患者表明,三种不同类型的尿路结石(形成原因不同)的治疗结果相似。URSL似乎是一种对所有结石类型均有效且安全的治疗方法,结果相当。