输尿管镜下钬激光治疗合并息肉的输尿管上段阴性结石（附60例报告）

目的探讨输尿管镜下钬激光治疗合并息肉的输尿管上段阴性结石的疗效。方法2008年1-12月采用输尿管镜下钬激光（美国科以人公司PowerSuite 20 W激光系统,光纤500μm）治疗合并息肉的输尿管上段阴性结石60例。经尿道输尿管镜直视下到达结石部位,采用钬激光腔内碎石治疗,同时消融息肉。结果手术时间15-70 min,平均21 min。60例息肉均一次治疗成功;除4例上段结石被冲入肾盂外,其余56例均单次原位碎石成功。术中未发生输尿管黏膜撕脱、输尿管穿孔、输尿管黏膜隧道等严重并发症。术后仅有轻微血尿,无低热、肾区疼痛等不适。60例随访3-12个月,平均5个月,均未发现结石残留及输尿管狭窄。结论输尿管镜下钬激光治疗合并息肉的输尿管上段阴性结石安全,疗效满意。

Holmium Laser Lithotripsy via Ureteroscope for Upper Urinary Tract Radiotransparent Calculi Complicated with Polyps

Objective To investigate the effect, safety, and skills of holmium laser lithotripsy by ureteroscopy for upper urinary tract radiotransparent calculi complicated with polyps. Methods From January to December 2008, 60 patients with upper urinary tract radiotransparent calculi complicated with polyps were treated by holmium laser lithotripsy （ Coherent PowerSuite 20 W, 500 μm） via a ureteroseope. The laser lithotrite was introduced to the stones, and the intraluminal stone was fragmented and melted by holmium laser simultaneously. Results The mean operation time of this series was 21 min （ 15 - 70 min）. The polyps was removed completely in one session in all of the cases except in 4 patients,whose upper calculi were flushed into the renal pelvis. No ureteral mucosa avulsion, perforation, false passage and other severe complications occurred. Some of the patients had mild haematuria after the operation without fever or renal pain. The patients were followed up for 3 to 12 months（ mean 5 months） ; none of them had residual stones or ureteral stricture during the period. Conclusions Holmium laser lithotripsy via ureteroscope is a safe and effective procedure for the treatment of upper urinary tract radiotransparent complicated with polyps.