Delepaul B, Lang H, Abram F, Saussine C, Jacqmin D
Service de Chirurgie Urologique, Hôpitaux Universitaires de Strasbourg, France.
Prog Urol. 1997 Sep;7(4):600-3.
We report the experience of a centre which treated symptomatic ureteric stones exclusively by ureteroscopy.
From 1987 to 1993, 379 patients underwent ureteroscopy for ureteric stones, corresponding to 231 men and 148 women, between the ages of 8 and 80 years. The stones were situated in the pelvic ureter in 78.9% of cases, iliac ureter in 15.8%, and lumbar ureter in 5.3% of cases. An 11 F or Gautier ureteroscope was used. The only intracorporeal lithotripsy method consisted of an ultrasound transducer. Finally, our department does not possess an extracorporeal lithotripsy apparatus allowing the treatment of ureteric stones.
The stone was eliminated immediately in 288 patients (76%), the stone was pushed back into the renal cavities in 40 patients (1.5%) and partial failures (residual fragments) or complete failures were observed in 51 patients (13.5%). 13 ureteric perforations (3.43%), treated by means of a double J ureteric stent, and one surgically drained urinoma were observed. 13 false passages of the ureteric meatus had an uneventful course by drainage with a double J stent.
Ureteroscopy remains an effective method for the treatment of ureteric stones. It is associated with a definite morbidity, probably higher in a University Centre in which future urologists are trained.
我们报告一家仅通过输尿管镜治疗有症状输尿管结石的中心的经验。
1987年至1993年,379例患者因输尿管结石接受输尿管镜检查,其中男性231例,女性148例,年龄在8岁至80岁之间。结石位于盆腔段输尿管的病例占78.9%,髂段输尿管的占15.8%,腰段输尿管的占5.3%。使用的是11F或戈蒂埃输尿管镜。唯一的体内碎石方法是超声换能器。最后,我们科室没有用于治疗输尿管结石的体外碎石设备。
288例患者(76%)结石立即被清除,40例患者(1.5%)结石被推回肾盂,51例患者(13.5%)观察到部分失败(残留碎片)或完全失败。观察到13例输尿管穿孔(3.43%),通过双J输尿管支架治疗,1例手术引流尿外渗。13例输尿管口假道通过双J支架引流后病情平稳。
输尿管镜检查仍然是治疗输尿管结石的有效方法。它伴有一定的发病率,在培训未来泌尿外科医生的大学中心可能更高。