Abstract：Objective: To evaluate the efficacy and safety of flexible ureteroscopy and holmium∶YAG laser lithotripsy for the treatment of complex proximal urinary tract calculi. Methods: A retrospective analysis was performed on 80 patients with complex proximal urinary tract calculi treated by flexible ureteroscopy employing a holmium∶YAG laser lithotripsy. The diameters of the calculi were 1.0-3.5 cm, with an average of 2.2 cm. The flexible ureteroscopy was inserted through access sheath for the lithotripsy, which employed a 230 μm holmium∶YAG laser fiber at a power setting of 6.4-9.6 W. Results: Among the 80 patients, phase I lithotripsy was performed on 70 patients, of which 3 subjects received emergency double J catheterization surgery due to acute renal failure and 7 subjects underwent a successful second surgery after 1-2 weeks of indwelling double J catheterization due to a ureteral stricture that hindered insertion of the access sheath. The surgical duration ranged from 30 to 180 min, with an average of 65 min. The postoperative hospitalization ranged from 2 to 12 days, with an average of 3.1 days. The postoperative stone-free rate within 1 month was 91.25%, and no serious complications occurred. Conclusions: Flexible ureteroscopy and holmium laser lithotripsy is a safe and effective treatment method for complex proximal urinary tract calculus.
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