Gould D L
Department of Surgery, John Peter Smith Hospital, Fort Worth, Texas, USA.
J Endourol. 1998 Feb;12(1):23-6. doi: 10.1089/end.1998.12.23.
Over the course of 18 months, 160 patients underwent endoscopic holmium:YAG laser surgery at our institution for the treatment of urolithiasis. After appropriate consent had been obtained, 127 patients were treated for ureteral calculi, 18 for renal calculi, and 15 for large bladder stones. All procedures were performed using the VersaPulse combination holmium:YAG/Nd:YAG laser by Coherent Inc., and all were done endoscopically using video guidance. Of the 16 patients treated percutaneously for renal calculi, 5 were rendered stone free (mean stone size 3.5 cm). Two patients with renal calculi were treated in a retrograde fashion. One had a 1-cm stone in an upper-pole calix with a narrow infundibulum, while the other had a stone just proximal to the ureteropelvic junction. Both patients were rendered stone free. Of the 127 patients with ureteral calculi, 46 had stents placed after fragmentation of their stones. To date, 123 patients in this group (97%) are free of stones. All 15 patients with bladder calculi had complete fragmentation of their stones. The Ho:YAG laser is effective and versatile in the treatment of urolithiasis.
在18个月的时间里，我院160例患者接受了钬激光内镜手术治疗尿路结石。在获得适当的同意后，127例患者接受输尿管结石治疗，18例接受肾结石治疗，15例接受膀胱大结石治疗。所有手术均使用相干公司的VersaPulse钬激光/钕激光联合激光设备，并且所有手术均在视频引导下通过内镜完成。在16例经皮治疗肾结石的患者中，5例结石清除（平均结石大小3.5厘米）。2例肾结石患者采用逆行方式治疗。1例患者上极肾盏有1厘米结石，漏斗部狭窄，另1例患者结石位于输尿管肾盂连接处近端。两名患者均结石清除。在127例输尿管结石患者中，46例在结石破碎后放置了支架。迄今为止，该组123例患者（97%）结石已清除。所有15例膀胱结石患者的结石均完全破碎。钬激光在尿路结石治疗中有效且用途广泛。
