Application of Intermittent Lung Inflation Combined with Rigid Ureteroscopy in Treating Upper Ureteral Stones That Were Not Fully Visible.
10.3881/j.issn.1000-503X.11105
- Author:
Feng Jin WANG
1
;
Hua Jian GUO
2
;
Guo Wei ZHENG
3
;
Hua Qian KUANG
1
;
Wei Wei QU
3
;
Bin Hong ZHU
1
;
Zhao Zhen HUANG
3
;
Yun Wen SHU
1
;
Pei HUANG
3
;
Hua Jian WU
1
Author Information
1. Department of Urology,Zhejiang Quhua Hospital,Quzhou,Zhejiang 324004,China.
2. Department of Urology,No 9 People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200011,China.
3. Department of Anesthesiology,Zhejiang Quhua Hospital,Quzhou,Zhejiang 324004,China.
- Publication Type:Journal Article
- Keywords:
intermittent lung inflation;
rigid ureteroscopy;
upper ureteral stone
- MeSH:
Humans;
Lithotripsy, Laser;
Retrospective Studies;
Ureteral Calculi;
diagnostic imaging;
Ureteroscopes;
Ureteroscopy
- From:
Acta Academiae Medicinae Sinicae
2019;41(6):793-798
- CountryChina
- Language:Chinese
-
Abstract:
To analyze the effectiveness and safety of intermittent lung inflation combined with rigid ureteroscopy in the treatment of upper ureteral stones that were not fully visible. The clinical and imaging data of 56 patients with upper ureteral stone undergoing rigid ureteroscopic lithotripsy combined with intermittent lung inflation in Zhejiang Quhua Hospital from March 2016 to October 2017 were retrospectively analyzed.Intermittentt lung inflation was used to change and stabilize the position of ureteral calculi during the operation,so as to ensure the visual field of ureteroscopy.Holmium laser lithotripsy was performed to remove the stones.Urinary tract abdominal plain X-ray or CT urography was performed 1 and 3 months after the operation to evaluate the residual stones and the clinical efficacy. Stones were successfully removed after a single attempt in 48 patients.In 5 patients,stones escaped into the kidney during ureteroscopic lithotripsy,and thus flexible ureteroscopy were performed.In 3 patients,a second session of auxiliary procedure was required,among whom 2 patients received extracorporeal shock wave lithotripsy and 1 patient underwent extracorporeal shock wave lithotripsy+ureteroscopic lithotripsy.The stone-free rates 1 and 3 months after surgery were 94.6%(53/56)and 100%(56/56),respectively.No severe complication such as ureter perforation,gross hematuria,septic shock,or pneumothorax occurred during and after surgery. Intermittent lung inflation in tracheal intubation under general anesthesia in patients with proximal ureteral stones that can not be fully visible during rigid ureteroscopic lithotripsy was feasible and reliable.It can effectively change the location of stones and thus enable safe and effective lithotripy.It expands the indications of rigid ureteroscopy for treating upper ureteral stones.
