半硬性输尿管镜联合气压弹道碎石术治疗输尿管结石

Semirigid ureteroscopy with pneumatic lithotripsy for ureteral stone.

作者信息

Dongol U Ms, Acharya L, Subba K, Khambu B, Joshi R, Shrestha S K, Singh D R

机构信息

Department of Surgery, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.

出版信息

J Nepal Health Res Counc. 2011 Apr;9(1):21-4.

PMID:22929707

Abstract

BACKGROUND

Ureteral stones present with acute loin to groin pain. The objective of this study is to find out the outcome and safety of semi-rigid ureterscopy with pneumatic lithotripsy for treatment of ureteral stones of >30 mm(2) and to assess the impact of size and location on stone free (SF) rate.

METHODS

Total 110 patients with isolated ureteral stone size>30 mm(2) were included in this study and treated with pneumatic lithotripsy using 8/9.8 Fr. Semi-rigid ureteroscope (Stiema Germany). Stones were fragmented into 2-3 mm particles and removed. Outcome parameters assessed at 3 months follow up were stone free rate(SF),Efficiency Quotient (EQ), and impact of stone size and site on SF/EQ was also analyzed. Similarly, patient demographics, procedures, patient related parameters and complications were also noted.

RESULTS

The overall SF rate at 3 months follow up was 69.33% and efficient Quotient (EQ) 52.52%. The SF/EQ for upper, middle and lower third of ureteral stone was 55/37.67, 61/43.57, 92/84.40 respectively (P-value< 0.001). The SF for stone size 30-110 mm(2) and >110 mm(2) was 78% and 67% respectively. There were no major complications seen. Overall minor complication rate was 5.45 % (minor ureteral perforations-5, urinoma formation 1).

CONCLUSIONS

Semi-rigid ureteroscopy with pneumatic lithotripsy is a safe, simple and effective procedure for ureteral stones with excellent success rate for distal ureteral stones. The stone free rate and EQ are statistically significant (P value<0.001) between upper, middle and lower ureteral stones. Stone size has a direct impact on the SF rate and EQ.

摘要

背景

输尿管结石表现为从腰部到腹股沟的急性疼痛。本研究的目的是了解使用气动碎石术的半硬性输尿管镜检查治疗直径大于30mm²的输尿管结石的疗效和安全性，并评估结石大小和位置对结石清除率（SF）的影响。

方法

本研究共纳入110例孤立性输尿管结石直径大于30mm²的患者，使用8/9.8Fr.半硬性输尿管镜（德国施蒂玛）进行气动碎石术治疗。结石被破碎成2 - 3mm的颗粒并取出。在3个月随访时评估的结果参数包括结石清除率（SF）、效率商（EQ），并分析结石大小和部位对SF/EQ的影响。同样，还记录了患者的人口统计学数据、手术情况、患者相关参数和并发症。

结果

3个月随访时的总体结石清除率为69.33%，效率商（EQ）为52.52%。输尿管结石上、中、下三分之一段的SF/EQ分别为55/37.67、61/43.57、92/84.40（P值<0.001）。结石大小为30 - 110mm²和大于110mm²的结石清除率分别为78%和67%。未观察到重大并发症。总体轻微并发症发生率为5.45%（轻微输尿管穿孔5例，尿瘤形成1例）。