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急诊输尿管镜检查作为输尿管结石的主要治疗方法:为何不可以?

Urgent ureterorenoscopy as a primary treatment for ureteral stone: why not?

作者信息

Uğur Ramazan, Yağmur İlyas

机构信息

Department of Urology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, Başakşehir Olympic Boulevard Road, 34480, Başakşehir, Istanbul, Turkey.

Department of Urology, Yenişehir, Viranşehir State Hospital, Viranşehir - Ceylanpınar Street, No:3, 63700, Viranşehir, Şanlıurfa, Turkey.

出版信息

Urolithiasis. 2024 Apr 23;52(1):69. doi: 10.1007/s00240-024-01569-0.

Abstract

To evaluate the feasibility of urgent ureteroscopy (uURS) and elective ureteroscopy (eURS) in the management of patients with renal colic due to ureteral stones. Patients who were operated for ureteral stones between September 2020 and March 2022 were determined retrospectively. The patients who were operated within the first 24 h constituted the uURS group, while the patients who were operated after 24 h were classified as eURS. No limiting factors such as age, gender and concomitant disease were determined as inclusion criteria. Patients with bilateral or multiple ureteral stones, bleeding diathesis, patients requiring emergency nephrostomy or decompression with ureteral JJ stent, and pregnant women were not included. The two groups were compared in terms of stone-free rate, complications, and overall outcomes. According to the inclusion-exclusion criteria, a total of 572 patients were identified, including 142 female and 430 male patients. There were 219 patients in the first group, the uURS arm, and 353 patients in the eURS arm. The mean stone size was 8.1 ± 2.6. The stone-free rate was found to be 87.8% (502) in general, and 92 and 85% for uURS and eURS, respectively. No major intraoperative or postoperative complications were observed in any of the patients. Urgent URS can be performed effectively and safely as the primary treatment in patients with renal colic due to ureteral stones. In this way, the primary treatment of the patient is carried out, as well as the increased workload, additional examination, treatment and related morbidities are prevented.

摘要

评估急诊输尿管镜检查(uURS)和择期输尿管镜检查(eURS)在治疗输尿管结石所致肾绞痛患者中的可行性。回顾性确定2020年9月至2022年3月间因输尿管结石接受手术的患者。在最初24小时内接受手术的患者构成uURS组,而在24小时后接受手术的患者分类为eURS组。未将年龄、性别和伴随疾病等限制因素确定为纳入标准。双侧或多发输尿管结石患者、出血性疾病患者、需要急诊肾造瘘或输尿管双J支架减压的患者以及孕妇均未纳入。比较两组的结石清除率、并发症和总体结局。根据纳入-排除标准,共确定572例患者,包括142例女性和430例男性患者。第一组即uURS组有219例患者,eURS组有353例患者。平均结石大小为8.1±2.6。总体结石清除率为87.8%(502例),uURS组和eURS组分别为92%和85%。所有患者均未观察到严重的术中或术后并发症。急诊URS可作为输尿管结石所致肾绞痛患者的主要治疗方法有效且安全地进行。通过这种方式,既对患者进行了主要治疗,又避免了工作量增加、额外检查、治疗及相关发病率。

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