Abstract：Objective: To investigate the effects of different operation plans in the treatment of patients with complex upper ureteral calculi (CUU) and the effect of stone removal and lithotripsy. Methods: The clinical data of 348 patients with CUU were analyzed retrospectively. Thirty-three patients were respectively selected from patients undergoing ureteoscopic pneumatic lithotripsy (URSL), percutaneous nephrolithotomy (PCNL), extracorporeal shock wave lithotripsy (ESWL) and retroperitoneal laparoscopic ureterolithotomy (RLU). They were included in group A, group B, group C and group D, respectively (a total of 132 effective cases enrolled in the study). The time of lithotripsy, operation process, intraoperative blood loss, total length of hospital stay, treatment costs and other perioperative indicators were compared among the four groups. The success rate of once operation, stone-free rate (SFR), rate of twice or more times operation and the incidence rate of postoperative related complications were recorded. The calculus components were analyzed. Results: The perioperative related indicators, success rates of once operation and SFR in group A and group C were significantly lower than those in group B and group D (P<0.05) while the success rates of twice or more times operation were significantly higher than those in group B and group D (P<0.05). During the postoperative 12 months of follow-up, the incidence rate of adverse reactions in group B (48.5%) was significantly higher than that in other three groups (P<0.05). The proportion of calcium oxalate calculus was the highest in all group (P>0.05). Conclusions: URSL has short duration and less trauma, but the success rate of once operation and SFR are low; PCNL is ideal for the treatment of SFR, but the risk of postoperative complications is high; The treatment costs of ESWL is low, with less trauma and patients do not need to be hospitalized after operation, but the success rate of once operation and SFR are low; The success rate of once operation and SFR of RLU are high, and the risk of postoperative complications is low however, there is a greater probability of accidental injury. Therefore, the best operation should be chosen according to the actual situation.
李文威，周微，丁智兵，伍文兵，朱寒亮. 复杂性输尿管上段结石患者的手术方案选取及取石碎石效果研究[J]. 微创泌尿外科杂志, 2016, 5(4): 213-217.
Li Wenwei, Zhou Wei, Ding Zhibing, Wu Wenbing, Zhu Hanliang. Selection of operation plan for patients with complex upper ureteral calculi and the effect of stone removal and lithotripsy. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2016, 5(4): 213-217.
