Urology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
World J Urol. 2024 Jul 10;42(1):392. doi: 10.1007/s00345-024-05073-3.
We sought to prospectively evaluate the impact of previously failed SWL on subsequent URS outcomes in the treatment of upper urinary tract stones.
Between May 2021 and May 2023, one hundred thirty-six patients with proximal ureteral stones < 1.5 cm and renal stones < 2.5 cm who were candidates for URS were prospectively assigned to a non-SWL group, which included patients without a history of failed SWL before URS, and a post-SWL group, which included patients with a history of failed SWL before URS. The success rate was the primary outcome. The perioperative data of the two groups were compared.
The stone-free rate was 83.3% in the post-SWL group versus 81.3% in the non-SWL group, and 8.3% in the post-SWL group versus 9.4% in the non-SWL group had clinically insignificant residual fragments. There was no significant difference in the stone-free rate or success rate between the groups. No significant differences in intraoperative fluoroscopy time, operative time, intraoperative stone appearance, perioperative complications, or the presence of embedded fragments in the ureteral mucosa were detected between the two groups.
Compared with patients who underwent primary URS, patients who underwent salvage URS for upper urinary tract stones had similar stone-free rates, success rates, operative times, fluoroscopy times, and complication rates without any significant differences.
本研究旨在前瞻性评估既往体外冲击波碎石术（SWL）失败对治疗上尿路结石行输尿管镜碎石术（URS）后结局的影响。
2021 年 5 月至 2023 年 5 月，136 例拟行 URS 的近端输尿管结石<1.5 cm 和肾结石<2.5 cm 患者被前瞻性分配至非 SWL 组（无 URS 前 SWL 失败史的患者）和 post-SWL 组（URS 前有 SWL 失败史的患者）。主要结局为手术成功率。比较两组患者的围手术期数据。
post-SWL 组的结石清除率为 83.3%，non-SWL 组为 81.3%，post-SWL 组有 8.3%的患者存在临床无意义的残石碎片，non-SWL 组为 9.4%。两组的结石清除率或成功率无显著差异。两组术中透视时间、手术时间、术中结石外观、围手术期并发症或输尿管黏膜内嵌入碎片的存在无显著差异。
与初次行 URS 的患者相比，因上尿路结石行挽救性 URS 的患者在结石清除率、成功率、手术时间、透视时间和并发症发生率方面无显著差异。
