Transurethral Flexible Ureteroscopic Holmium Laser Lithotripsy for Treatment of Kidney and Upper Ureteral Calculi

摘要

This paper aims at studying the efficacy and safety of flexible ureteroscopic holmium laser lithotripsy for treatment of kidney and upper ureteral calculi. Methods. The duration of operation, postoperative complication, postoperative calculus clearance rate of this surgery were analyzed based on 58 patients with kidney and upper ureteral calculi treated by holmium laser under the flexible ureteroscope as clinical data (Kidney or upper ureteral calculi was diagnosed by ultrasound, CT or IVP, etc.) by using retrospective analysis. Results. The successful inserting rate of single flexible ureteroscope is 93.1% (54/58), mean lithotripsy time is (56.1±4.8) min, and the total successful lithotripsy rate is 98.2% (57/58). Plain abdominal radiograph or CT was rechecked after one month, which indicated that the calculus clearance rate was 91.3% (53/58). All patients had no complications. Conclusion. The efficacy of holmium laser lithotripsy for treatment of kidney and upper ureteral calculi under the flexible ureteroscope was high. The operation was short and safe, with few complications and high success rate. Clinically, the extracorporeal shock-wave lithotripsy (ESWL) was first choice in treating kidney stones and most ureteral calculi <2cm [1]. Minimally invasive lithotripsy by rigid ureteroscope can be performed if upper ureteral calculi fails in vitro lithotripsy. However, the upper ureteral calculi are easy moving up to pelvis or calyx thereby leading to rigid ureteroscope unable to finish majority of lithotriptic therapies during endoluminal lithotripsy. In contrast, the flexible ureteroscope highlights its advantages because it can almost explore the calculi occurred in the whole urinary cavity. This paper studied 58 patients with kidney and upper ureteral calculi treated by holmium laser lithotripsy under the flexible ureteroscope in our hospital between June 2014 and June 2015. The efficacy is satisfied and reported as follows.