Curative Effect of Holmium Laser Lithotripsy through Flexible Ureteroscope for Renal Calculi of over 2 cm in Diameter_West China Medical Journal

Authors：

 WangLiang , LiuJiwen , DiaoSijun , HuangYike , YangHang , LiuXiangdan , CaoWenfeng , LiShadan , ChenWeiguo , LiXiaowei , YangWei , ZhouTingting

Department of Urology, General Hospital of Chengdu Military Region of PLA, Chengdu, Sichuan 610083, P. R. China;

Corresponding?author：

Keywords：

Renal calculi; Flexible ureteroscope; Holmium laser

DOI：

10.7507/1002-0179.201600498

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To evaluate the safety and efficacy of flexible ureteroscopic lithotripsy for patients with renal calculi of more than 2 cm in diameter. Methods The Clinical data of 37 patients with renal calculi of more than 2 cm in diameter treated with holmium laser lithotripsy through flexible ureteroscope between December 2012 and March 2015 were retrospectively analyzed. In this group, stone diameter was between 2.0 cm and 3.5 cm, including 22 cases of single stone and 15 cases of multiple stones. Preoperative ureteral stents were indwelt in all the patients for 1-2 weeks. After dilation of the ureter with F8/9.8 rigid ureteroscope, the ureteral access sheath for flexible ureteroscope was inserted to the target ureter followed by flexible ureteroscope. Stones were fragmentized by holmium laser and the power was not more than 30 W (1.0-1.5 J/15-20 Hz). Results The success rate of ureteroscopic insertion was 100% (37/37). The operation time ranged from 40 to 185 minutes with a mean of 73 minutes. After the operation, one patient had sepsis, and was cured after positive anti-infection treatment. No other serious complications occurred. Four and 8 weeks after surgery, the free-stone rate was 73.0% (27/37) and 86.5% (32/37) respectively. Conclusion The flexible ureteroscopic lithotripsy is advantageous in less trauma, fewer complications, quick recovery and higher free-stone rate. It can be used to treat renal calculi of over 2 cm in diameter selectively.

Citation： WangLiang, LiuJiwen, DiaoSijun, HuangYike, YangHang, LiuXiangdan, CaoWenfeng, LiShadan, ChenWeiguo, LiXiaowei, YangWei, ZhouTingting. Curative Effect of Holmium Laser Lithotripsy through Flexible Ureteroscope for Renal Calculi of over 2 cm in Diameter. West China Medical Journal, 2016, 31(11): 1814-1817. doi: 10.7507/1002-0179.201600498 Copy

1.	那彥群. 中國泌尿外科疾病診斷治療指南(2014版)[M].北京:人民衛生出版社, 2014:137-147.
2.	European Association of Urology. Guidelines on Urolithiasis (revised 2015)[EB/OL].(2015-03-06)[2015-08-14].http://uroweb.org/wp-content/uploads/22-Urolithiasis-LR-full.pdf.
3.	Hyams ES, Munver R, Bird VG, et al. Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm:a multi-institional experience[J].J Endourol, 2010, 24(10):1583-1588.
4.	劉建河, 潘春武, 李瑞鵬, 等. 輸尿管軟鏡下鈥激光碎石處理直徑>2 cm腎結石[J].中國微創外科雜志, 2014, 14(2):132-137.
5.	Aboumarzouk OM, Monga M, Kata SG, et al. Flexible ureteroscopy and laser lithotripsy for stones> 2 cm:a systematic review and meta-analysis[J].J Endourol, 2012, 26(10):1257-1263.
6.	Semins MJ, Trock BJ, Matlagabr BR. The safety of ureteroscopy during pregnancy:a systematic review and meta-analysis[J].J Urol, 2009, 181(1):139-143.
7.	程躍, 施小東, 胡嘉盛, 等. 電子輸尿管軟鏡下鈥激光碎石術[J].中國內鏡雜志, 2011, 17(2):212-214, 217.
8.	Auge BK, Pietrow PK, Lallas CD, et al. Ureteral access sheath provides protection against elevated renal pressure during routine flexible ureteroscopic stone manipulation[J].J Endourol, 2004, 18(1):33-36.
9.	田雨, 盧劍, 肖春雷, 等. 輸尿管軟鏡在泌尿外科疾病診斷及治療中的應用[J].中國微創外科雜志, 2013, 13(4):322-326.
10.	Osman Y, Harraz AM, El-Nahas AR, et al. Clinically insignificant residual fragments:an acceptable term in the computed tomogyaphy era?[J].Urology, 2013, 81(4):723-726.
11.	孫穎浩. 泌尿系結石微創治療的若干問題[J].中國微創外科雜志, 2011, 11(1):6-8, 12.
12.	Geavlete P, Multescu R, Geavlete B. Influence of pyelocaliceal anatomy on the success of flexible ureteroscopic approach[J].J Endourol, 2008, 22(10):2235-2239.
13.	Preminger GM. Management of lower pole renal calculi:shock wave lithotripsy versus percutaneous nephrolithotomy versus flexible ureteroscopy[J].Urol Res, 2006, 34(2):108-111.
14.	孫穎浩, 戚曉升, 王林輝, 等. 輸尿管軟鏡下鈥激光碎石術治療腎結石(附51例報告)[J].中華泌尿外科雜志, 2002, 23(11):681-682.
15.	郭應祿. 泌尿外科內鏡診斷治療學[M].北京:北京大學醫學出版社, 2004:116-118.
16.	劉齊貴, 麻偉青, 張文滔, 等. 輸尿管軟鏡技術的臨床應用[J].中國誤診學雜志, 2011, 11(13):3053-3055.

1. 那彥群. 中國泌尿外科疾病診斷治療指南(2014版)[M].北京:人民衛生出版社, 2014:137-147.
2. European Association of Urology. Guidelines on Urolithiasis (revised 2015)[EB/OL].(2015-03-06)[2015-08-14].http://uroweb.org/wp-content/uploads/22-Urolithiasis-LR-full.pdf.
3. Hyams ES, Munver R, Bird VG, et al. Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm:a multi-institional experience[J].J Endourol, 2010, 24(10):1583-1588.
4. 劉建河, 潘春武, 李瑞鵬, 等. 輸尿管軟鏡下鈥激光碎石處理直徑>2 cm腎結石[J].中國微創外科雜志, 2014, 14(2):132-137.
5. Aboumarzouk OM, Monga M, Kata SG, et al. Flexible ureteroscopy and laser lithotripsy for stones> 2 cm:a systematic review and meta-analysis[J].J Endourol, 2012, 26(10):1257-1263.
6. Semins MJ, Trock BJ, Matlagabr BR. The safety of ureteroscopy during pregnancy:a systematic review and meta-analysis[J].J Urol, 2009, 181(1):139-143.
7. 程躍, 施小東, 胡嘉盛, 等. 電子輸尿管軟鏡下鈥激光碎石術[J].中國內鏡雜志, 2011, 17(2):212-214, 217.
8. Auge BK, Pietrow PK, Lallas CD, et al. Ureteral access sheath provides protection against elevated renal pressure during routine flexible ureteroscopic stone manipulation[J].J Endourol, 2004, 18(1):33-36.
9. 田雨, 盧劍, 肖春雷, 等. 輸尿管軟鏡在泌尿外科疾病診斷及治療中的應用[J].中國微創外科雜志, 2013, 13(4):322-326.
10. Osman Y, Harraz AM, El-Nahas AR, et al. Clinically insignificant residual fragments:an acceptable term in the computed tomogyaphy era?[J].Urology, 2013, 81(4):723-726.
11. 孫穎浩. 泌尿系結石微創治療的若干問題[J].中國微創外科雜志, 2011, 11(1):6-8, 12.
12. Geavlete P, Multescu R, Geavlete B. Influence of pyelocaliceal anatomy on the success of flexible ureteroscopic approach[J].J Endourol, 2008, 22(10):2235-2239.
13. Preminger GM. Management of lower pole renal calculi:shock wave lithotripsy versus percutaneous nephrolithotomy versus flexible ureteroscopy[J].Urol Res, 2006, 34(2):108-111.
14. 孫穎浩, 戚曉升, 王林輝, 等. 輸尿管軟鏡下鈥激光碎石術治療腎結石(附51例報告)[J].中華泌尿外科雜志, 2002, 23(11):681-682.
15. 郭應祿. 泌尿外科內鏡診斷治療學[M].北京:北京大學醫學出版社, 2004:116-118.
16. 劉齊貴, 麻偉青, 張文滔, 等. 輸尿管軟鏡技術的臨床應用[J].中國誤診學雜志, 2011, 11(13):3053-3055.

West China Medical Journal

Curative Effect of Holmium Laser Lithotripsy through Flexible Ureteroscope for Renal Calculi of over 2 cm in Diameter

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content