Flexible Ureteroscopy Combined with Holmium Laser Lithotripsy for Renal Stones of Longer than 2 cm in Diameter_West China Medical Journal

Authors：

 LuoHua , WangXiaobo , LiaoGaoyuan , LiuChen , WangChunxia , LiuLunbo

Department of Urology, the Second People's Hospital of Deyang, Deyang, Sichuan 618000, P. R. China;

Corresponding author：

Keywords：

Renal calculi; Flexible ureteroscope; Holmium laser

DOI：

10.7507/1002-0179.201600131

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 renal stones of longer than 2 cm in diameter. Methods From August 2012 to July 2014, 15 selected patients with renal calculi of longer than 2 cm in diameter underwent flexible ureteroscopic lithotripsy with holmium laser by the same surgeon. Preoperative indwelling ureteral stent was performed for 1-2 weeks, and super smooth guidewire was inserted after checking and dilation of the ureter was performed with F8.0/9.8 rigid ureterosope. Flexible ureteroscope sheath was inserted through guidewire. Ureterosope was followed by flexible ureteroscope sheath. Larger stone fragments were removed by basket. Results The success rate of ureteroscopic insertion was 100% and no severe intraoperative complications occurred. The operation time ranged from 50 to 125 minutes averaging 75. No ureteral perforations or pyonephrosis or acute renal insufficiency occurred. Four patients had high fever after operation and improved after positive anti-infection treatment. After 2 days, the stone-free rate was 73.3% (11/15) by reviewing KUB. The follow-up of 4 weeks showed the stone-free rate was 86.7% (13/15). One case of stone fragments retained in the middle and lower ureter and the fragments were taken out by ureteroscopic lithotripsy. The other case of renal residual calculi was operated by flexible ureteroscope holmium laser lithotripsy in two stage. Conclusion Flexible ureteroscopic lithotripsy is a favorable option for patients with renal stones of longer than 2 cm in diameter, especially for recurrent renal calculi.

Citation： LuoHua, WangXiaobo, LiaoGaoyuan, LiuChen, WangChunxia, LiuLunbo. Flexible Ureteroscopy Combined with Holmium Laser Lithotripsy for Renal Stones of Longer than 2 cm in Diameter. West China Medical Journal, 2016, 31(3): 495-498. doi: 10.7507/1002-0179.201600131 Copy

1.	肖克兵, 刘晓龙, 臧亚晨, 等. 经皮肾镜碎石取石术与输尿管软镜钬激光碎石术治疗肾结石的临床观察[J]. 江苏医药, 2013, 39(11):1336-1337.
2.	Prabhakar M. Retrograde ureteroscopic intrarenal surgery for large (1.6-3.5 cm) upper ureteric/renal calculus[J]. J Urol, 2010, 26(1):46-49.
3.	曾国华, 李逊. 经皮肾镜取石术[M]. 北京:人民卫生出版社, 2011:54-55.
4.	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.
5.	Bader MJ, Gratzke C, Walther S, et al. Efficacy of retrograde ureteropyeloscopic Holmium laser lithotripsy for intrarenal calculi >2 cm[J]. Urol Res, 2010, 38(5):397-402.
6.	徐彦, 张犁, 张平, 等. 电子输尿管软镜钬激光碎石治疗复杂肾结石45例分析[J]. 现代泌尿外科杂志, 2013, 18(1):40-42, 55.
7.	舒建平. 输尿管软镜钬激光碎石术治疗上尿路结石的疗效分析[J]. 中外医疗, 2013, 32(20):14-15.
8.	程跃, 严泽军, 谢国海, 等. "粉末化碎石"在输尿管软镜治疗肾结石中的应用[J]. 微创泌尿外科杂志, 2013, 2(3):210-212.
9.	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-institutional experience[J]. J Endourol, 2010, 24(10):1583-1588.
10.	王应东, 乐立虎, 郑斌, 等. 组合式输尿管软镜联合钬激光碎石术治疗肾结石的研究[J]. 中外医疗, 2014(15):104-105.
11.	高小峰, 李凌, 彭泳涵, 等. 输尿管软镜联合钬激光治疗2~4cm肾结石疗效分析[J]. 微创泌尿外科杂志, 2013, 2(1):47-49.
12.	Fabrizio MD, Behari A, Bagley DH. Ureteroscopic management of intrarenal calculi[J]. J Urol, 1998, 159(4):1139-1143.
13.	Perlmutter AE, Talug C, Tarry WF, et al. Impact of stone location on success rates of endoscopic lithotripsy for nephrolithiasis[J]. Urology, 2008, 71(2):214-217.
14.	Breda A, Ogunyemi O, Leppert JT, et al. Flexible ureteroscopy and laser lithotripsy for multiple unilateral intrarenal stones[J]. Eur Urol, 2009, 55(5):1190-1196.
15.	曾国华, 叶章群. 输尿管软镜术[M]. 北京:人民卫生出版社, 2014:117-118.
16.	叶利洪, 李雨林, 李王坚, 等. 肾下盏解剖结构对输尿管软镜下钬激光碎石治疗肾下盏结石疗效的影响[J]. 中华泌尿外科杂志, 2013, 34(1):24-27.
17.	Resorlu B, Oguz U, Resorlu EB, et al. The impact of pelvicaliceal anatomy on the success of retrograde intrarenal surgery in patients with lower Pole renal stones[J]. Urology, 2012, 79(1):61-66.
18.	Cohen J, Cohen S, Grasso M. Ureteropyeloscopic treatment of large, complex intrarenal and proximal ureteral calculi[J]. BJU Int, 2013, 111(3 Pt B):E127-E131.
19.	张晨光, 卢海庆, 李异军. 复杂肾结石术后残留结石的排石疗效观察[J]. 中国中西医结合杂志, 2005, 25(9):847-848.
20.	程玲玲. 输尿管软镜钬激光碎石术手术配合[J]. 齐齐哈尔医学院学报, 2014, 35(9):1365-1366.
21.	程跃, 刘冠琳. 输尿管软镜治疗鹿角形结石的发展与展望[J]. 微创泌尿外科杂志, 2013, 2(3):163-165.
22.	Turk C, Knoll T, Petrik A, et al. Guidelines on urolithiasis. Uroweb 2014[M/OL]. http://uroweb.org/fileadmin/guidelines/Guidelines-2014_5_June_2014.pdf..

1. 肖克兵, 刘晓龙, 臧亚晨, 等. 经皮肾镜碎石取石术与输尿管软镜钬激光碎石术治疗肾结石的临床观察[J]. 江苏医药, 2013, 39(11):1336-1337.
2. Prabhakar M. Retrograde ureteroscopic intrarenal surgery for large (1.6-3.5 cm) upper ureteric/renal calculus[J]. J Urol, 2010, 26(1):46-49.
3. 曾国华, 李逊. 经皮肾镜取石术[M]. 北京:人民卫生出版社, 2011:54-55.
4. 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.
5. Bader MJ, Gratzke C, Walther S, et al. Efficacy of retrograde ureteropyeloscopic Holmium laser lithotripsy for intrarenal calculi >2 cm[J]. Urol Res, 2010, 38(5):397-402.
6. 徐彦, 张犁, 张平, 等. 电子输尿管软镜钬激光碎石治疗复杂肾结石45例分析[J]. 现代泌尿外科杂志, 2013, 18(1):40-42, 55.
7. 舒建平. 输尿管软镜钬激光碎石术治疗上尿路结石的疗效分析[J]. 中外医疗, 2013, 32(20):14-15.
8. 程跃, 严泽军, 谢国海, 等. "粉末化碎石"在输尿管软镜治疗肾结石中的应用[J]. 微创泌尿外科杂志, 2013, 2(3):210-212.
9. 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-institutional experience[J]. J Endourol, 2010, 24(10):1583-1588.
10. 王应东, 乐立虎, 郑斌, 等. 组合式输尿管软镜联合钬激光碎石术治疗肾结石的研究[J]. 中外医疗, 2014(15):104-105.
11. 高小峰, 李凌, 彭泳涵, 等. 输尿管软镜联合钬激光治疗2~4cm肾结石疗效分析[J]. 微创泌尿外科杂志, 2013, 2(1):47-49.
12. Fabrizio MD, Behari A, Bagley DH. Ureteroscopic management of intrarenal calculi[J]. J Urol, 1998, 159(4):1139-1143.
13. Perlmutter AE, Talug C, Tarry WF, et al. Impact of stone location on success rates of endoscopic lithotripsy for nephrolithiasis[J]. Urology, 2008, 71(2):214-217.
14. Breda A, Ogunyemi O, Leppert JT, et al. Flexible ureteroscopy and laser lithotripsy for multiple unilateral intrarenal stones[J]. Eur Urol, 2009, 55(5):1190-1196.
15. 曾国华, 叶章群. 输尿管软镜术[M]. 北京:人民卫生出版社, 2014:117-118.
16. 叶利洪, 李雨林, 李王坚, 等. 肾下盏解剖结构对输尿管软镜下钬激光碎石治疗肾下盏结石疗效的影响[J]. 中华泌尿外科杂志, 2013, 34(1):24-27.
17. Resorlu B, Oguz U, Resorlu EB, et al. The impact of pelvicaliceal anatomy on the success of retrograde intrarenal surgery in patients with lower Pole renal stones[J]. Urology, 2012, 79(1):61-66.
18. Cohen J, Cohen S, Grasso M. Ureteropyeloscopic treatment of large, complex intrarenal and proximal ureteral calculi[J]. BJU Int, 2013, 111(3 Pt B):E127-E131.
19. 张晨光, 卢海庆, 李异军. 复杂肾结石术后残留结石的排石疗效观察[J]. 中国中西医结合杂志, 2005, 25(9):847-848.
20. 程玲玲. 输尿管软镜钬激光碎石术手术配合[J]. 齐齐哈尔医学院学报, 2014, 35(9):1365-1366.
21. 程跃, 刘冠琳. 输尿管软镜治疗鹿角形结石的发展与展望[J]. 微创泌尿外科杂志, 2013, 2(3):163-165.
22. Turk C, Knoll T, Petrik A, et al. Guidelines on urolithiasis. Uroweb 2014[M/OL]. http://uroweb.org/fileadmin/guidelines/Guidelines-2014_5_June_2014.pdf..

Previous Article
Surgical Treatment for Complicated Proximal Ulnar Fracture
Next Article
Prevention of Postoperative Palpebral Edema by Stellate Ganglion Block in Patients Undergoing Intracranial Aneurysm Surgery

West China Medical Journal

Flexible Ureteroscopy Combined with Holmium Laser Lithotripsy for Renal Stones of Longer than 2 cm in Diameter

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content