Clinical application of endoscopic combined intrarenal scopic surgery for complicated upper urinary calculi
10.3760/cma.j.cn112330-20200327-00234
- VernacularTitle:双镜联合治疗复杂性上尿路结石的临床应用
- Author:
Weiwen YU
1
;
Enhui LI
;
Mi ZHOU
;
Alin JI
;
Guodong LIAO
;
Yuelong ZHANG
;
Zujie MAO
;
Xiang HE
Author Information
1. 浙江省人民医院(杭州医学院附属人民医院)泌尿外科，杭州 310014
- From:
Chinese Journal of Urology
2020;41(6):459-462
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the safety and efficacy of endoscopic combined intrarenal scopic surgery for complicated upper urinary calculi.Methods:The clinical data of 117 patients with complicated upper urinary calculi treated by simultaneous percutaneous nephroscopy combined with flexible ureteroscopy from March 2013 to February 2020 were retrospectively analyzed, including 71 males and 46 females, aged 31-73 years, with an average age of 45 years old. There were 29 cases of multiple kidney and ureteral stones, 22 cases of staghorn stones, 19 cases of postoperative residual stones, 18 cases secondary to urinary diversion, 13 cases of ureteral stricture with stones after kidney transplantation/ureteroplasty/endoscopic lithotripsy, 10 cases of isolated kidney, and 6 cases of caliceal diverticular stones. The maximum diameters of calculi were 13-45 mm, with an average of 27 mm.Results:All operative procedures of 117 patients were successful by one session. The mean operation time was (91.6±10.2) min. All cases were treated with single-channel lithotripsy combined antegrade percutaneous nephroscopy with retrograde flexibl eureteroscopy. An abdominal X-ray (KUB) or non-contrast CT was taken 3 to 7 days after the operation. There was no serious bleeding or infection after the operation, and the first-stage stone-free rate was 87.2% (102/117).Conclusions:The strategy of simultaneous antero-retrograde endoscopic combined intrarenal surgery for complicated upper urinary calculi can improve the success rate and first-stage stone-free rate, and reduce the number of percutaneous renal channel leading to the increasing safety of operation. It is an effective means of endourological management of urolithiasis.
