Analysis of complications following semirigid ureteroscopy lithotripsy for the treatment of ureteral stones
Zhang Peixin1, Jia Hongliang1, Ma Hesuti1, Pu Chuenlin1, Zhang Jianjun1,Tang Mao1, Tang Zhetian1, Li Ming1, Li Yun2
1Department of Urology, The People's Hospital of Xinjiang Uroqur Autonomous Reigion, Uromqi 830001, China; 2Department of Urology, The People's Hospital of Xinyu
Abstract：Objective: To review intraoperative complications following ureteroscopy lithotripsy (URL) according to our experience with URL in the treatment of ureteral stones and stratify intraoperative complications following URL according to the modified Satava classification system. Methods: The clinical data of 1 563 patients (877 males and 686 females) were retrospectively. Intraoperative complications were recorded according to modified Satava classification system. Grade 1 complications included incidents without consequences for the patients; grade 2 complications, which are treated intraoperatively with endoscopic surgery (grade 2a) or required endoscopic re-treatment (grade 2b); and grade 3 complications included incidents requiring open or laparoscopic surgery. Results: The stones were completely removed in 1 348 (86.3%). The overall incidence of intraoperative complications was 13.8%. The most common complications were proximal stone migration (4.6%), mucosal injury (3.8%), bleeding (2.3%), inability to reach stone (2.1%), ureteral perforation (1.15%) and ureteral avulsion (0.13%), mucosal tears or false-route (3.15%). According to modified Satava classification system, grade 1 accounted for 4.9%, grade 2a for 4.6%, grade 2b for 3.74%, and grade 3 for 0.56% respectively. Conclusions: Modified Satava classification is a quick and simple system for using to describ the severity of intraoperative URL complications and this grading system will help to compare for the available surgical outcomes from different centers.
张培新,贾宏亮,马合苏提,蒲春林,张建军,唐矛,唐泽天,李鸣,李赟. 评估经输尿管镜处理输尿管结石并发症[J]. 微创泌尿外科杂志, 2015, 4(2): 84-87.
Zhang Peixin, Jia Hongliang, Ma Hesuti, Pu Chuenlin, Zhang Jianjun,Tang Mao, Tang Zhetian, Li Ming, Li Yun. Analysis of complications following semirigid ureteroscopy lithotripsy for the treatment of ureteral stones. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2015, 4(2): 84-87.
[1]Jeromin L, Sosnowski M. Ureteroscopy in the treatment of ureteral stones: over 10 years' experience. Eur Urol, 1998,34(4):344-349. [2]Parker BD, Frederick RW, Reilly TP, et al. Efficiency and cost of treating proximal ureteral stones: shock wave lithotripsy versus ureteroscopy plus holmium:yttrium-aluminum-garnet laser. Urology, 2004,64(6):1102-1106. [3]Elashry OM, Elgamasy AK, Sabaa MA, et al. Ureteroscopic management of lower ureteric calculi: a 15-year single-centre experience. BJU Int, 2008,102(8):1010-1017. [4]Lytton B, Weiss RM, Green DF. Complications of ureteral endoscopy. J Urol, 1987,137(4):649-653. [5]Onal B, Dogan HS, Satar N, et al. Factors affecting complication rates of percutaneous nephrolithotomy in children: results of a multi-institutional retrospective analysis by the Turkish pediatric urology society. J Urol, 2014,191(3):777-782. [6]Tepeler A, Resorlu B, Sahin T, et al. Categorization of intraoperative ureteroscopy complications using modified Satava classification system. World J Urol, 2014,32(1):131-136. [7]Dongol UM, Acharya L, Subba K, et al. Semirigid ureteroscopy with pneumatic lithotripsy for ureteral stone. J Nepal Health Res Counc, 2011,9(1):21-24. [8]Smaldone MC, Cannon GM Jr, Wu HY, et al. Is ureteroscopy first line treatment for pediatric stone disease. J Urol, 2007,178(5):2128-2131. [9]El-Assmy A, Hafez AT, Eraky I, et al. Safety and outcome of rigid ureteroscopy for management of ureteral calculi in children. J Endourol, 2006,20(4):252-255. [10]吕建军,蒋玖金,李旵灿,等.输尿管镜下碎石术治疗输尿管结石(附248例报告).安徽医学,2013,34(7):879-881. [11]张家俊,李庆文,韩锋,等.输尿管镜气压弹道碎石术失败常见原因分析及对策.蚌埠医学院学报,2012,37(3):259-261. [12]涂传仕,崔维奇,谌辉鹏,等.经输尿管镜钬激光碎石术治疗输尿管结石(附350例报告).临床泌尿外科杂志. 2012,27(11):843-844. [13]范永毅.输尿管镜治疗输尿管结石2652例临床分析.微创医学,2008,3(6):651-652. [14]Satava RM. Identification and reduction of surgical error using simulation. Minim Invasive Ther Allied Technol, 2005,14(4):257-261. [15]Aridogan IA, Zeren S, Bayazit Y, et al. Complications of pneumatic ureterolithotripsy in the early postoperative period. J Endourol, 2005,19(1):50-53. [16]Leijte JA, Oddens JR, Lock TM. Holmium laser lithotripsy for ureteral calculi: predictive factors for complications and success. J Endourol, 2008, 22(2):257-260. [17]Daniels GF Jr, Garnett JE, Carter MF. Ureteroscopic results and complications:experience with 130 cases. J Urol, 1988,139(4):710-713. [18]Castillo OA, Rodriguez-Carlin A, Lopez-Vallejo J, et al. Complications associated with laparoscopic adrenalectomy: Description and standardized assessment. Actas Urol Esp, 2014,38(7):445-450. [19]Abdelrahim AF, Abdelmaguid A, Abuzeid H, et al. Rigid ureteroscopy for ureteral stones: factors associated with intraoperative adverse events. J Endourol, 2008,22(2):277-280. [20]Brandt AS, von RFC, Lazica DA, et al. Ureteral reconstruction after ureterorenoscopic injuries. Urologe A, 2010,49(7):812-821. [21]Harmon WJ, Sershon PD, Blute ML, et al. Ureteroscopy: current practice and long-term complications. J Urol, 1997,157(1):28-32. [22]Johnson DB, Pearle MS. Complications of ureteroscopy. Urol Clin North Am, 2004,31(1):157-171. [23]Abdel-Razzak OM, Bagley DH. Clinical experience with flexible ureteropyeloscopy. J Urol, 1992,148(6):1788-1792. [24]Schatloff O, Lindner U, Ramon J, et al. Randomized trial of stone fragment active retrieval versus spontaneous passage during holmium laser lithotripsy for ureteral stones. J Urol, 2010,183(3):1031-1035.
