Treatment of upper urinary tract calculi with flexible cystoscope conducted holmium laser lithotripsy via percutaneous nephrostomy
- VernacularTitle:经皮肾造瘘软膀胱镜下钬激光碎石术治疗上尿路结石
- Author:
Jian LU
;
Chunlei XIAO
;
Lulin MA
;
Shenrong ZHUANG
;
Yuqing LIU
;
Xiaojun TIAN
;
Rongxin ZHANG
- Publication Type:Journal Article
- Keywords:
Upper urinary tract calculus;
Flexible cystoscope;
Holmium laser;
Lithotripsy
- From:
Chinese Journal of Urology
2008;29(5):326-328
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the efficacy and safety of flexible cystoscope conducted holmium laser lithotripsy via percutaneous nephrostomy in the treatment of upper urinary tract calculi.Methods The flexible cystoscope conducted holmium laser lithotripsy via percutaneous nephrostomy was performed on 26 patients from Jul 2005 to Jan 2007. Among these patients, 8 had bilateral renal calculi and ureteral calculi, 5 had multiple renal calculi, 4 had renal calyx calculi and 9 had ureteral calculi. The average diameter of the calculus was 2.2 cm (range from 1.0-3.2 cm). Four patients had mild hydronephrosis, others had moderate or severe hydronephrosis. Insufficient renal function was noted in 13 cases. The procedure was performed via a single tract through the middle calyx under the ultrasonic guidance in all cases.Results Twenty-two cases achieved stone free at primary procedure, secondary procedure was needed in 4 cases. A 18 F tract was used in 18 cases and 24 F tract was used in the left 8 cases. The average operation time was 72 min, stone-free rate was 96.2%(25/26),and there was no blood transfusion. One patient had fever after the procedure and recovered 2 days after the administration of antibiotics. No other complication was recorded. In an average 11 month follow-up in 22 patients, hydronephrosis reduction was significant observed by ultrasound scan. No calculus relapse was found.Conclusions Flexible cystoscope conducted holmium laser lithotripsy via percutaneous nephrostomy is an effective and minimally invasive technique for the treatment of upper urinary tract calculus. It has the advantages in dealing with the calyx and ureteral calculus located in the proximal or middle segment as well.
