输尿管软镜下钬激光碎石治疗经皮肾镜取石术后残留结石

目的探讨输尿管软镜下钬激光治疗经皮。肾镜取石术后残留结石的疗效。方法收集经皮肾镜取石术后残留结石患者43例，残石直径6—30mm。经留置输尿管扩张鞘置入Wolf输尿管软镜（6／8．8F，上下弯180／270°）抵达肾盂，以200μm光纤，〈30W钬激光粉碎残留结石，较大碎石用取石篮取出。结果43例患者均找到残余结石，结石寻及率100％（43／43），42例患者成功粉碎结石，碎石成功率97．7％（42／43）。8例联合经皮肾镜碎石取石，无严重并发症发生。结论输尿管软镜钬激光碎石治疗经皮肾镜取石术后残留结石安全、有效。

Holmium laser lithotripsy with flexible ureteroscope for residual calculi by percutaneous nephrolithotomy

Objective To explore the effect of holmium laser lithotripsy with flexible ureteroseope for residual calcub by percutaneous nephrolithotomy （PCNL）. Methods 43 cases with residual calculi by PCNL were collected. The stone size ranged from 6 mm to 30 ram. The flexible ureteroscope reached pelvis through ureterectasia-seabbard to remove the calculi with holmium laser lithotripsy by 200 μm optical fiber and less than 30 W power or flexible ureter forceps. Results There was no serious complication in 43 cases. All calculi were found. The success rate is 100%, and the calculi of 42 cases were treated successfully with the success rate 97.7%. PCNL was used in combination in 8 cases without any serious complications occurred. Conclusion It is safe and effective to remove the residual calculi with holmium laser lithotripsy with flexible ureteroscope by PCNL.