输尿管软镜钬激光碎石术在马蹄肾结石中的应用

杨春; 高小峰; 周铁; 彭泳涵; 李凌; 许传亮; 王林辉; 孙颖浩

输尿管软镜钬激光碎石术在马蹄肾结石中的应用

- 1 第二军医大学长海医院泌尿外科(上海, 200433

详细信息

通讯作者: 孙颖浩,E-mail:sunyh@medmail.com.cn

中图分类号: R691.4

收稿日期: 2011-09-22

Flexible ureterorenoscopy with holmium laser in the management of stones in the horseshoe kidney（Report of 13 cases）

- Department of Urology, Changhai Hospital, the Second Military Medical University, Shanghai, 200433, China

More Information

Corresponding author: SUN Yinghao, E-mail: sunyh@medmail.com.cn

Received Date: 22 September 2011

摘要

摘要: 目的:探讨输尿管软镜钬激光碎石术治疗马蹄肾结石的安全性及有效性。方法:回顾性分析2005年1月~2010年12月采用输尿管软镜钬激光碎石术治疗马蹄肾结石13例患者资料。结石直径平均为1.7(1.2~2.3)cm。主要临床症状为腰痛、尿路感染、血尿。6例患者有ESWL史,2例曾行经皮肾镜取石术。术前1周均留置双J管,均行尿培养、静脉尿路造影及双肾CT检查。术中均先放置输尿管扩张鞘,然后置入输尿管软镜抵达肾盂。术后第1天及2个月复查KUB平片、B超或双肾CT平扫。术后检查无残石或结石残块＜3 mm视为碎石成功。结果:13例患者均顺利放置镜鞘并置入输尿管软镜,进镜成功率100%。患者碎石成功12例(92.3%)。1例术后结石残块略大于3 mm,行ESWL处理。平均手术时间90 min,平均住院2 d。无手术并发症发生。术后症状均消失。结论:输尿管软镜钬激光碎石术治疗马蹄肾结石是一种可供选择的安全、有效、微创治疗方法。
- 输尿管软镜 /
- 钬激光 /
- 马蹄肾结石
Abstract: Objective:To evaluate the therapeutic effect of flexible ureterorenoscopy (F-URS) with holmium laser in treating stones in the horseshoe kidney (HSK).Method:We retrospectively reviewed the records of 13 patients who underwent F-URS using a holmium laser from January 2005 to December 2010 for HSK stones.The average stone diameter was 1.7 cm (range1.2-2.3 cm).The presenting symptoms were renal colic,urinary tract infection,or hematuria.F-URS was used in as an alternative after the failure of extracorporeal shock wave lithotripsy in 6 patients and percutaneous nephrolithotomy failure in 2 patients.At one week before operations,all patients was placed the Double-J stent and underwent urinalysis,urine culture,intravenous urography with tomograms,renal computed tomography (CT).The ureteral access sheaths was placed firstly during operation,and then ureterorenoscope was inserted into the renal pelvis.Follow-up examination was performed after two months with plain radiography of the kidneys,ureters,and bladder and renal ultrasonography,or noncontrast CT.Success was dened as stone-free status or residual fragments ＜3 mm.Result:Flexible ureterorenoscopes were successfully placed in all patients.The operative success rate was 92.3%.All patients were symptom free after operation.The average operative time and hospital stay were 90 minutes and 2 days,respectively.No severe complications occured.Conclusion:F-URS with the holmium laser is a safe,efficient minimal invasive procedure as a reasonable alternative for treating HSK stones.
- fexible ureterorenoscope /
- holmium laser /
- horseshoe stone

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