Hofbauer J, Tuerk C, Höbarth K, Hasun R, Marberger M
Department of Urology, University of Vienna, Austria.
World J Urol. 1993;11(1):54-8. doi: 10.1007/BF00182172.
As documented by follow-up data on ureteric stones in 1259 ureteric units treated, ESWL in situ on advanced lithotriptors with stone location by ultrasonography and fluoroscopy was successful without any retrograde ureteric manipulation in 98% of stones in the upper, 71% in the iliac, and 84% in the distal ureter; 85% of the units were stone-free within 3 months: ancillary measures were needed in 11% and the stone-free state was reached after a median of 39 days. The results obtained with treatment after manipulation of the stone from the upper and mid-ureter by retrograde instrumentation were similar, but ancillary measures were needed in 20% of cases. Endoscopic management with rod-lens ureteroscopes was highly efficient in the distal and mid-ureter, but involved a complication rate of about 11% and required general anaesthesia. In the upper ureter it was abandoned in favour of the two former methods. Endoscopic stone removal has been greatly facilitated by the development of ultrathin, semirigid ureteroscopes 6.2-9 F in diameter, as well as by laser and pneumatic lithotriptors that operate through their minute working ports. Of the stones impacted in 127 ureteric units, 97% were successfully managed at the first attempt, involving an overall complication rate of 6%.(ABSTRACT TRUNCATED AT 250 WORDS)
在1259个接受治疗的输尿管单位的输尿管结石随访数据中记录显示，使用先进碎石机通过超声和荧光镜定位结石进行原位体外冲击波碎石术（ESWL），上段输尿管结石98%无需任何逆行输尿管操作即成功，髂部输尿管结石成功率为71%，远端输尿管结石成功率为84%；85%的单位在3个月内结石清除：11%需要辅助措施，结石清除状态在中位39天后达到。通过逆行器械操作处理上段和中段输尿管结石后进行治疗的结果相似，但20%的病例需要辅助措施。使用棒状透镜输尿管镜进行内镜治疗在远端和中段输尿管高效，但并发症发生率约为11%且需要全身麻醉。在上段输尿管，这种方法被前两种方法取代。直径6.2 - 9F的超薄半刚性输尿管镜以及可通过其微小工作通道操作的激光和气动碎石机的发展极大地促进了内镜下结石清除。在127个输尿管单位受嵌顿的结石中，97%在首次尝试时成功处理，总体并发症发生率为6%。（摘要截取自250字）
