Abstract：Objective: To investigate the efficacy and safety of flexible ureteroscopic lithotripsy (FURS) for renal staghorn calculi. Methods: From October 2015 to December 2017, 54 cases of renal staghorn calculi treated with FURS were retrospectively analyzed, including 41 cases of partial staghorn calculi and 13 cases of complete staghorn calculi. The Double-J stent was indwelled 2 weeks before lithotripsy. Both dusting and fragmenting techniques were used in the process of lithotripsy. Fragments larger than 2 mm were retrieved using baskets. During the follow-up period of 2 to 4 weeks after surgery, the stone free rate (SFR) was evaluated. If there were residuals of calculi, a second stage of FURS was performed. Results: All patients underwent operation successfully. The average calculi diameter was (34.7 ± 15.7) mm. Among them, 18 patients underwent one-stage FURS, 24 patients underwent 2nd-stage FURS, and 12 patients underwent 3rd-stage FURS. The average procedure of FURS was 1.9 times. The one-stage SFR accounted for 33.3% (18/54), and the overall SFR accounted for 83.3% (45/54). Overall, complication rate was 35.2% (19/54). Among them, there were 8 cases of fever (T>38.5°C); 3 cases of urinary sepsis; 2 cases of ureteral perforation; 4 cases of postoperative stone street, including 1 case of solitary kidney undergoing emergency operation with FURS to remove the stone street, which caused ureter obstruction and acute renal insufficiency; 2 cases of subcapsular renal hematoma. Postoperative hospital stay was 1 to 5 days, with an average of (2.0 ± 1.1) days. Conclusion: The FURS can be used as an ideal option for the treatment of complex staghorn calculi with good efficiency and safety. But the one-stage SFR was relatively low and staged procedures were often necessary to achieve a high SFR.
朱轶勇, 孙丰, 邓铮, 王聪, 邵怡, 鲁军. 输尿管软镜治疗肾脏鹿角形结石的疗效分析[J]. 微创泌尿外科杂志, 2020, 9(4): 226-229.
ZHU Yiyong, SUN Feng, DENG Zheng, WANG Cong, SHAO Yi, LU Jun. Therapeutic effectiveness of flexible ureteroscopy in the treatment of renal staghorn calculi. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(4): 226-229.
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