Abstract：Objective： To analyze the causes of complications related to ureteroscopic holmium laser lithotripsy, and to explore the risk factors of complications and the countermeasures for prevention and treatment. Methods： 603 cases of upper urinary tract calculi treated by retrograde intrarenal surgery (RIRS) in our department from July 2015 to December 2017 were reviewed. The basic data, stone size, number of stone sites, number of stones, operation time, hydronephrosis degree, stone clearance rate and incidence of surgical complications were statistically analyzed. Results： The success rate of the first-stage operation in 603 patients was 84.4%, the stone clearance rate was 89.7% at 4th week after operation, and the incidence of surgical complications was 3.8%. There were no cases of conversion to open surgery and no deaths. According to the occurrence of postoperative complications, 603 cases were divided into complications group and non-complications group for single factor analysis. There was no significant difference in age, number of stone sites, number of stones and degree of hydronephrosis between the two groups (P>0.05). There was significant difference in gender, stone size, whether ureteral stent was reserved or not and operation time (P<0.05). Multivariate Logistic regression analysis revealed that gender, stone size, whether to reserve ureteral stent and operation time were risk factors for complications of ureteroscopic holmium laser lithotripsy. Conclusion： Flexible ureteroscope holmium laser lithotripsy is an effective method for the treatment of upper urinary tract calculi, with less surgical trauma and low incidence of complications. The occurrence of complications can be reduced by reserving ureteral stent, shortening the operation time and selecting medium-sized upper urinary tract calculi for surgery.
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