Bishop M C, Lawrence W T, Lemberger R J
Br J Urol. 1987 Feb;59(2):137-41. doi: 10.1111/j.1464-410x.1987.tb04804.x.
From 1983 to 1986 140 patients underwent surgery for ureteric calculus. In approximately 30% "blind" basket extraction was considered appropriate and continued to be effective. Increasing expertise with the rigid ureterorenoscope led to a considerable reduction in open ureterolithotomy (15% in 1985-86), the majority following failed ureteroscopic extraction. In the same year both "blind" basket extraction and ureteroscopy were successful in 82 and 86% of attempts respectively. Electrohydraulic and ultrasonic lithotripsy were used in 12 patients to reduce large impacted calculi. The commonest complication of ureteroscopic stone surgery was perforation; this occurred in 14% of cases, though it was usually trivial and near the vesicoureteric junction. Perforations higher in the ureter tended to follow endoscopic lithotripsy and were often associated with urinary extravasation. Extra-ureteric stone fragments were also occasionally observed in such cases. There were no serious sequelae, although the in-patient stay was prolonged beyond the 48 h customary for uncomplicated extraction. The results suggest that ureteroscopic stone extraction, which can be conveniently introduced into urological practice, should become a standard endoscopic procedure.
1983年至1986年期间，140例患者接受了输尿管结石手术。约30%的患者采用“盲目”篮式取石术被认为是合适的，且该方法持续有效。随着硬性输尿管肾镜技术的日益成熟，开放性输尿管切开取石术的比例大幅下降（1985 - 1986年为15%），大多数是在输尿管镜取石失败后进行的。同年，“盲目”篮式取石术和输尿管镜取石术的成功率分别为82%和86%。12例患者采用了电液压碎石术和超声碎石术来处理较大的嵌顿性结石。输尿管镜结石手术最常见的并发症是穿孔；穿孔发生在14%的病例中，不过通常情况较轻，且多发生在膀胱输尿管连接处附近。输尿管上段的穿孔往往发生在内镜碎石术后，常伴有尿外渗。在这些病例中偶尔也会观察到输尿管外的结石碎片。尽管住院时间超过了单纯取石术通常的48小时，但并未出现严重的后遗症。结果表明，输尿管镜取石术操作简便，可引入泌尿外科临床实践，应成为一种标准的内镜手术。
