输尿管镜下钬激光治疗输尿管良性狭窄伴结石35例临床分析

目的分析输尿管镜钬激光治疗输尿管良性狭窄伴结石的方法及效果。方法 2010年12月至2012年12月运用输尿管镜钬激光治疗输尿管良性狭窄伴结石35例,男26例,女9例;年龄(42.97±7.85)岁;狭窄段长度0.2~1.6cm,结石最大径0.5~2.1cm。结果成功行狭窄段钬激光内切开并碎石33例。手术时间30~90min,平均(44.97±10.97)min。术后平均住院(4.94±1.72)d,双J管留置8周。随访3~27个月,平均(13.03±5.78)个月。2例术后分别6个月、9个月再狭窄,因狭窄段较长行开放手术狭窄段切除对端吻合治愈。结论输尿管镜钬激光治疗严格选择的输尿管良性狭窄伴结石安全、高效、微创、预后好。

Clinical analysis of treatment of benign ureteral stricture and calculi by holmium laser lithotripsy and endoureterotomy

Objective To assess the method and efficacy of holmium laser lithotripsy and endoureterotomy for treating benign ureteral stricture and calculi.Methods A total of 35 cases （26 male,9 female,average age 43 years） underwent holmium laser for benign ureteral stricture with calculi （length of stricture 0.2～1.6 cm,maximum diameter of calculus 0.5～2.1 cm） during Dec.2010 to Dec.2012.Results 33 cases successfully underwent holmium laser lithotripsy and endoureterotomy.The operation time ranged 30～90 min （average 45 min）.The mean postoperative stay was 5 days,and D-J indwelling was 8 weeks.Median followup was 13 months （ranged 3～27 months）.Two cases of recurrent stricture （6 and 9 months respectively after surgery） received open surgery resection and anastomosis due to long narrow segments.Conclusion Holmium laser lithotripsy and endoureterotomy is safe,highly effective,and minimally invasive to treat strictly chosen benign ureteral stricture and calculi with good prognosis.