Clinical research of ureteroscopic holmium laser lithotripsy combined with occluder & forceps for the treatment of intact ureteral calculi
Tao Yingbing1, Ma Song1, Wang Hongbing1, Li Qiang1, Jiang Fujin1, Xu Ping2
1.Department of Urology, Huaian Second People's Hospital of Jiangsu Province, Huaian 223002, China; 2.Department of Huaian Maternal and Child Health Hospital of Jiangsu Province
Abstract：Objective: To investigate the clinical efficacy of ureteroscopic holmium laser lithotripsy combined with occluder & forceps for the treatment of intact ureteral calculi. Methods: The clinical data of 82 cases of unilateral intact ureteral calculi (30 cases of lower ureteral stones, 23 cases of middle ureteral stones, and 29 cases of upper ureteral stones) treated by ureteroscopic holium laser lithotripsy combined with occluder & forceps from June 2013 to March 2016 in our hospital were retrospectively analyzed. The operation time, stone clearance rate, and postoperative complications were analyzed. Results: It worthed (5.0-14.5) min in lower ureter, (5.5-32.5) min in middle ureter, and (7.5-43.0) min in upper segment of the operation in research. Three days after surgery, KUB examination revealed 1 case of stone residual to the renal pelvis in the lower uretera with the net rate being 96.67%. There was 1 case of stone residual in the middle uretheral stones with the net rate being 95.65%. Another 1 case displaced to the renal pelvis and 1 case remained in the upper ureterald, which the net rate was 93.10%. No ureteral perforation or ureteral mucosa avulsion occurred in these operations. Figh fever occurred in 5 cases and cured by anti infection. The gross hematuria in 7 cases was improved after treatment with bladder irrigation after the operation. Conclusions: The application of ureteroscopic holium laser lithotripsy combined with occluder & forceps for intact ureteral calculi can significantly increase the stone-free rate, reduce ureteroscopic lithotripsy stone drift, and shorten the hospitalization time. It will become a kind of important means of treatment of intact ureteral calculi with more safely and more efficiently.
陶拥兵，马松，王洪兵，李强，姜福金，徐屏. 输尿管镜钬激光联合封堵器治疗输尿管结石的临床研究[J]. 微创泌尿外科杂志, 2016, 5(4): 203-205.
Tao Yingbing, Ma Song, Wang Hongbing, Li Qiang, Jiang Fujin, Xu Ping. Clinical research of ureteroscopic holmium laser lithotripsy combined with occluder & forceps for the treatment of intact ureteral calculi. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2016, 5(4): 203-205.
[1]Teichman JM, Rao RD, Rogenes VJ, et al. Ureteroscopic management of ureteral calculi: Electrohydraulic versus holmium: YAG lithotripsy. J Urol, 1997,158(4):1357-1361. [2]Dretler SP. Ureteroscopy for proximal ureteral calculi: prevention of stone migration. J Endourol, 2000,14(7):565-567. [3]Lee H, Ryan T, Teichman JM, et al. Stone retropulsion during holmium: YAG lithhotripsy. J Urol, 2003,169:881-885. [4]Ahmed M, Pedro RN, Kieley S, et al. Systematic evaluationof ureteral occlusion devices: insertion, deployment, stone migration,and extraction. Urology, 2009,73(5):976-980. [5]Wang CJ, Huang SW, Chang CH. Randomized trial of N-Trap forproximal ureteral stones. Urology, 2011,77(3):553-557. [6]Sarkissian C, Paz A, Zigman O, et al. Safety and efficacy of a novel ureteral occlusion device. Urology, 2012,80(1):32-37. [7]李天,李逊,何永忠,等.输尿管管路封堵器在输尿管镜钬激光碎石术中的应用.广东医学,2012,33(10):1440-1441. [8]Holley PG, Sharma SK, Perry KT, et al. Assessment of novel ureteral occlusion device and comparison with stone cone in prevention of stone fragment migration during lithotripsy. J Endourol, 2005,19(2):200-203. [9]陈奇,王立鹤,潘家骅,等.一种新型输尿管管路封堵器在输尿管镜钬激光碎石术中的应用初探.临床泌尿外科杂志,2011,26(5):358-360. [10]Farahat YA, Elbahnasy AE, Elashry OM. A randomized prospective controlled study for assessment of different ureteral occlusion devices in prevention of stone migration during pneumatic lithotripsy. Urology, 2011,77(1):30-35. [11]Ding H, Wang Z, Du W, et al. N-Trap in prevention of stone migration during ureteroscopic lithotripsy for proximal ureteral stones: a meta-analysis. J Endourol, 2012,26(2):130-134.
