Bilen C Y, Mahalati K, Sahin A, Tekin I, Ozen H, Remzi D
Department of Urology, Hacettepe University Medical School, Ankara, Turkey.
Int Urol Nephrol. 1997;29(3):301-6. doi: 10.1007/BF02550926.
A total of 140 ureteroscopies in 119 patients done between January 1992 and December 1994 at the Department of Urology, Hacettepe University Hospital, were reviewed. Factors such as previous ESWL therapy, previous surgery and use of in situ lithotripsy were noted. Success was defined as complete removal or disintegration and partial removal of the lower ureteral stones. All successes were confirmed by plain abdominal X-rays postoperatively. Of 140 stone manipulations attempted in 119 patients 106 (75.7%) were successful (in 80 by retrieval and in 26 by disintegration using electrohydraulic or laser). Perforation occurred in 4 of 13 cases where electrohydraulic lithotripsy was used for disintegration of stones. Extraction by ureteroscopic manipulation following extracorporeal shock wave lithotripsy (ESWL) was successful in all of the 12 cases of lower ureteral calculi. The success rate was found to be low for lower ureteral stones in patients with previous open surgery (2/9). A total of 43.2% of the patients were medically indicated to be hospitalized following the procedure with a mean hospitalization time of 5 days (ranging in between 1 to 7 days). Ureteroscopy is an effective method for management of lower ureteral stones. Use of the electrohydraulic lithotriptor may be associated with a high percentage of complications. Previous ESWL may be associated with a high rate of success. Results in patients with previous open surgery are not encouraging. Although all patients can be subjected to the procedure on an outpatient basis, a significant percentage need a short hospitalization.
回顾了1992年1月至1994年12月在哈杰泰佩大学医院泌尿外科为119例患者进行的总共140次输尿管镜检查。记录了诸如先前的体外冲击波碎石术（ESWL）治疗、先前的手术以及原位碎石术的使用等因素。成功定义为输尿管下段结石完全清除或碎裂以及部分清除。所有成功情况均在术后通过腹部平片证实。在119例患者中尝试的140次结石处理中，106次（75.7%）成功（80次通过取出，26次通过使用电液压或激光碎裂）。在13例使用电液压碎石术进行结石碎裂的病例中有4例发生穿孔。体外冲击波碎石术（ESWL）后通过输尿管镜操作取出在所有12例输尿管下段结石病例中均成功。发现先前接受开放手术的患者输尿管下段结石的成功率较低（2/9）。总共43.2%的患者在手术后根据医学指征需要住院，平均住院时间为5天（范围为1至7天）。输尿管镜检查是治疗输尿管下段结石的有效方法。使用电液压碎石器可能会有较高比例的并发症。先前的ESWL可能与高成功率相关。先前接受开放手术的患者的结果并不乐观。虽然所有患者都可以在门诊接受该手术，但相当比例的患者需要短期住院。
