输尿管硬镜联合钬激光碎石治疗输尿管上段结石

目的：探讨输尿管硬镜联合钬激光碎石治疗输尿管上段结石的有效性与安全性。方法：1999年11月～2003年4月期间，共治疗26例病人，其中男15例，女11例，年龄9～83岁，有3例病人同时行双侧手术，2例为孕妇，孤立肾2例，输尿管狭窄3例，马蹄肾1例。结果：26例病人中，术后复查25例完全无石，无石率为96％，平均手术时间37．5min，平均住院日3．5d，有8例为门诊手术。23例一次手术成功，无术中并发症，术后并发症1例，为尿路感染。共有16例(62％)术后留置双J管，未放置双J管的病人并未因此发生明显并发症。结论：对不适宜ESWL或ESWL失败的病人，输尿管硬镜联合钬激光碎石治疗输尿管上段结石是一种更为有效、安全的方法。

TREATMENT OF UPPER URETERAL CALCULI USING RIGID URETEROSCOPE AND HOLMIUM:YAG LASER LITHOTRIPSY

Objective:To investigate the effectiveness and s afety of holmium:YAG laser lithotripsy under ureteroscopy for managing upper ure teral calculi.Methods:Ureteroscopic holimium:YAG laser lithotripsy was perfor med in 26 patients between November 1999 and April 2003, including 15 males and 11 females 9 to 83 years old with upper ureteral calculi. Bilateral procedures d uring the same session in 3, pregnant females in 2, solitary kidney in 2, ureter al stricture in 3, horseshoe kidney in 1.Results:Overall 25 of the 26 patients (96%) were stone-free. Ave rage operative time was 37.5 minutes. The mean hospitalizations time was 3.5 da ys, while 8 cases were treated on an outpatients basis.Twenty-three cases were r endered s tone-free by a single ureteroscopic procedure. No patient had intraoperatively c omplications. One patient had urinary tract infection postoperatively. Overall 1 6 cases (62%) were stented postoperatively. No patient without a stent had compl ications.Conclusions:Holmium:YAG laser lithotripsy is a highly effective and safe treatment modality for managing upper ureteral calculi, especially thos e failure or contraindication to shock wave lithotripsy.