Abstract：Objective: To compare the efficiency and safety of two procedures, ureteroscopic lithotripsy (URL) combined with ESWL and minimally invasive percutaneous nephrolithotomy (MPCNL), for the treatment of complicated upper ureteral calculi, and investigate the selection of medical management for complicated upper ureter calculi. Methods: 210 cases of complicated upper ureter calculi were treated with URL combined with ESWL from January 2007 to August 2009, and 132 cases with MPCNL from September 2009 to April 2011. No patients experienced serious complications following URL combined with ESWL. Results: In the URL combined with ESWL cases, the stone fragmentation rate on one session was 90.95% (191/210), and the stone free rate was 80.95% (170/210) and 88.09% (185/210) one week and one month after operation respectively. In the MPCNL cases, the stone fragmentation rate on one session was 98.48% (130/132) (P<0.05), and the stone free rate was 98.48% (130/132) (P<0.05) one week and one month after operation. One patient experienced severe renal access tract hemorrhage after percutaneous nephrolithotomy. Conclusions: The therapeutic effect of URL combined with ESWL for complicated upper ureteral calculi is satisfactory. The therapeutic effect of MPCNL for the treatment of complicated upper ureteral calculi has comparative advantage but there is higher risk of complication. For the complicated upper ureteral calculi the medical management should be definited according to medical technology and facilities, patient's expectation and risk of complications.
周立权,黎承杨,杨占斌,汪小明,王翔,黄海鹏,关晓峰,邓耀良. 两种微创手术治疗复杂性输尿管上段结石比较研究[J]. 微创泌尿外科杂志, 2015, 4(2): 92-94.
Zhou Liquan, Li Chengyang, Yang Zhanbin, Wang Xiaoming,Wang Xiang, Huang Haipeng, Guan Xiaofeng, Deng Yaoliang,. A comparison of two surgical procedures for complicated upper ureteral calculi. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2015, 4(2): 92-94.
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