Department of Urology, The University of Hong Kong - Shenzhen Hospital, Shenzhen, Guangdong, China (mainland).
Department of Surgery, The University of Hong Kong - Shenzhen Hospital, Shenzhen, Guangdong, China (mainland).
Am J Case Rep. 2023 Mar 10;24:e939021. doi: 10.12659/AJCR.939021.
BACKGROUND The removal of concurrent ureteral and renal stones within a single procedure has always been a challenge for urological surgeons. The incorporation of single-use digital flexible ureteroscopes into laparoscopic ureterolithotomy procedures has demonstrated effective removal of concurrent stones with a good clearance rate and decreased risk of bleeding and trauma. We report the successful removal of a unilateral upper ureteral stone and a smaller renal stone with this procedure. CASE REPORT A 60-year-old man visited the outpatient clinic with an ultrasonography report that revealed a large proximal ureteral stone with moderate hydronephrosis, accompanied by bilateral renal stones and prostatic hyperplasia. He had been experiencing urinary urgency for a year and was determined to undergo lithotomy. Due to his longstanding history of coronary artery disease and myocardial ischemia, the urologists decided that concurrent stone removal within an operation would be the best treatment. A preoperative computed tomography urogram measured the left ureteral and renal stones to be 2.0×0.8 cm and 0.6 cm, respectively. Both stones were successfully removed by laparoscopic ureterolithotomy using a single-use digital flexible ureteroscope. The patient had an uneventful recovery and remained well 1 month post-operation. CONCLUSIONS The application of single-use digital flexible ureteroscopes for laparoscopic ureterolithotomy has demonstrated safety, efficiency, and cost-effectiveness. The authors believe that it is a safe alternative for the removal of concurrent ureteral and renal stones, especially in patients with multiple comorbidities.
在单次手术中同时去除输尿管和肾结石一直是泌尿外科医生面临的挑战。将一次性使用的数字柔性输尿管镜应用于腹腔镜输尿管切开取石术中，已被证明可有效去除同时存在的结石，具有较高的结石清除率，且出血和创伤风险较低。我们报告了一例使用该方法成功去除单侧上段输尿管结石和较小肾结石的病例。
一名 60 岁男性因超声检查报告发现大的近端输尿管结石伴中度肾积水，同时伴有双侧肾结石和前列腺增生而就诊于门诊。他已经有一年的尿急病史，决定进行碎石术。由于他患有长期的冠心病和心肌缺血，泌尿科医生决定在一次手术中同时去除结石。术前 CT 尿路造影测量左输尿管和肾结石分别为 2.0×0.8cm 和 0.6cm。使用一次性使用的数字柔性输尿管镜进行腹腔镜输尿管切开取石术，成功地去除了这两个结石。患者术后恢复顺利，1 个月后情况良好。
一次性使用的数字柔性输尿管镜在腹腔镜输尿管切开取石术中的应用具有安全性、高效性和成本效益。作者认为，对于同时存在的输尿管和肾结石的去除，尤其是在合并多种疾病的患者中，这是一种安全的替代方法。
