Original Article
Analysis of the efficacy of three different methods of ureteroscopic surgery in the treatment of upper ureteral calculi
Zhang Lyuwen, Song Yan, Fei Xiang
Published 2021-05-01
Cite as Clin Med Chin, 2021, 37(3): 275-279. DOI: 10.3760/cma.j.cn101721-20201018-00010
Abstract
ObjectiveTo introduce the experience and clinical efficacy of a new type of negative pressure suction ureteroscope in the treatment of upper ureteral calculi, and compare it with traditional rigid ureteroscope and flexible ureteroscope lithotripsy.
MethodsFrom January 2018 to January 2020, 160 patients with upper ureteral incarcerated calculi who were treated in Shengjing Hospital Affiliated to China Medical University were included in this study, and their clinical data were retrospectively analyzed.There were 50 cases in the rigid ureteroscope group, 54 cases in the flexible ureteroscope group and 56 cases in the new negative pressure combined ureteroscope group.The differences of operation time, hospital stay, stone free rate and postoperative complications were observed and compared among the three groups.According to whether the maximum diameter of the stone is more than 1.5 cm, the subgroups were analyzed to further compare the curative effect of the three groups.
ResultsAll the 160 operations were completed successfully and none of them were converted to open surgery.The stone free rate of the new negative pressure suction ureteroscope Group (90.0% (18/20))was higher than that of the flexible ureteroscope Group (61.9% (13/21)) and the rigid ureteroscope Group (55.6% (10/18)), χ 2=8.49, P<0.001). The stone free rate in the first month after operation was also superior (96.4% (54/56), 77.7% (42/54), 74.0% (37/50), χ2=5.48, P=0.01). The stone subgroup analysis showed that when the stone diameter increased (>1.5 cm), the net stone rate of the new negative pressure suction ureteroscope Group[91.6% (22 / 24)] was better than that of the flexible ureteroscope Group (62.5% (15/24)) and the rigid ureteroscope Group (50.0 (8/16))(χ2=6.480, P=0.001).
ConclusionCompared with the traditional ureteroscopic lithotripsy, the new negative pressure suction ureteroscopic lithotripsy has higher initial and overall stone free rate, and higher safety factor.For the patients with stone diameter>1.5 cm, the new negative pressure suction ureteroscope lithotripsy has more advantages.
Key words:
Upper ureteral calculi; Ureteroscopic lithotripsy; Negative pressure suction; Curative effect
Contributor Information
Zhang Lyuwen
Department of Urology Surgery, Shengjing Hospital affiliated to China Medical University, Shenyang 110000, China
Song Yan
Department of Urology Surgery, Shengjing Hospital affiliated to China Medical University, Shenyang 110000, China
Fei Xiang
Department of Urology Surgery, Shengjing Hospital affiliated to China Medical University, Shenyang 110000, China