小输尿管硬镜联合钬激光碎石术治疗复杂性输尿管结石(附100例报告)

目的探讨经小输尿管硬镜联合钬激光碎石术治疗复杂性输尿管结石的有效性及安全性。方法 2009年5月～2010年9月采用经小输尿管硬镜联合钬激光碎石术治疗复杂性输尿管结石100例患者:76例伴有患侧轻中度肾盂积水,24例伴有患侧重度肾盂积水;72例合并结石远端输尿管狭窄,42例合并息肉或肉芽组织包裹,15例为ESWL治疗失败后。结果 95例患者单次手术碎石成功,单次手术成功率达95%,3例结石在钬激光碎石过程中移位至肾盏,术后再行ESWL治疗治愈,2例患者因输尿管迂曲明显无法进一步手术而改开放手术。无输尿管穿孔、断裂等严重并发症发生。结论小输尿管硬镜联合钬激光碎石术治疗复杂性输尿管结石安全、有效。

SMALL URETEROSCOPIC COMBINE HOLMIUM LASER LITHOTRIPSY TREATMENT OF COMPLICATED URETERAL CALCULI (100 CASES)

Objective To investigate the effectiveness and safety of small Ureteroscopic holmium laser lithotripsy for complicated ureteral calculi.Methods From May 2009 to September 2010 100 patients treated by small Ureteroscopic holmium laser lithotripsy for complicated ureteral calculi：76 cases complicated with mild to moderate ipsilateral hydronephrosis,24 cases with ipsilateral severe hydronephrosis,72 cases with stenosis distal to ureteral stones,42 patients with polyps or granulation tissue wrapping,and15 cases undergone treatment failure after ESWL.Results 95 patients were removed stone successfully in single operation,the single operation success rate is 95%.In 3 cases stones shifting to the calyx in the process of holmium laser lithotripsy,they were cured after ESWL treatment,2 patients with no further surgery because of ureteral tortuosity were converted to open surgery.No ureteral perforation,fracture and other serious complications.Conclusion Small Ureteroscopic holmium laser lithotripsy treatment of complicated ureteral calculi is safe and effective.