[1]李涛 李权 刘建河﹡.一期与分期输尿管软镜治疗双侧上尿路结石的疗效比较[J].中国微创外科杂志,2016,16(09):816-819.
　Li Tao,Li Quan,Liu Jianhe..Samesession Bilateral Versus Staged Unilateral Flexible Ureteroscopic Lithotripsy for Upper Urinary System Stones[J].Chinese Journal of Minimally Invasive Surgery,2016,16(09):816-819.
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一期与分期输尿管软镜治疗双侧上尿路结石的疗效比较()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
16
期数:
2016年09期
页码:
816-819
栏目:
临床研究
出版日期:
2016-09-09

文章信息/Info

Title:
Samesession Bilateral Versus Staged Unilateral Flexible Ureteroscopic Lithotripsy for Upper Urinary System Stones
作者:
李涛 李权 刘建河﹡
（上海交通大学医学院附属新华医院泌尿外科，上海200092）
Author(s):
Li Tao;  Li Quan;  Liu Jianhe.
Department of Urology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092,China
关键词:
输尿管软镜; 结石; 结石清除率
Keywords:
Flexible ureteroscope; Calculi; Stone free rate
文献标志码:
A
摘要:
目的探讨一期与分期输尿管软镜下碎石术（flexible ureteroscopic lithotripsy，FURL）治疗双侧上尿路结石的临床疗效。方法我院2012年9月～2015年5月一期输尿管软镜下钬激光碎石术治疗双侧上尿路结石 29例(一期手术组)，分期输尿管软镜治疗双侧上尿路结石 20例（分期手术组），比较2组总手术时间、总住院时间、结石清除率、并发症发生率。结果2组患者均顺利完成手术。一期手术组总手术时间明显短于分期手术组［（71.0±19.0） min vs. (112.6±268) min，t=-6.366,P=0.000］，2组总住院时间无统计学差异［（6.9±3.6）d vs. (8.4±2.1) d, t=-1.674, P=0.101］。2组患者术后4周结石清除率分别为79.3%（23/29）、80.0%（16/20）,无统计学差异（χ2=0.000,P=1.000）；2组术后并发症发生率无统计学差异［20.7%(6/29) vs. 15.0%（3/20）, χ2=0.017, P=0.896］。结论一期双侧输尿管软镜钬激光碎石术可有效、安全治疗双侧上尿路结石，但仍需严格把握手术适应证。
Abstract:
ObjectiveTo analyze the efficacy and safety of samesession bilateral and staged unilateral flexible ureteroscopic lithotripsy (FURL) with holmium laser for the treatment of upper urinary system stones. MethodsClinical data of 29 patients who underwent samesession bilateral FURL (samesession group) and 20 patients who received staged unilateral FURL (staged group) from September 2012 to May 2015 at this hospital were analyzed retrospectively. The overall operation time,overall hospital stay, stone free rate (SFR) and overall complication rate were compared between the two groups. ResultsThe operations were successfully completed in both groups. The overall operative time was significantly longer for staged unilateral FURL than bilateral FURL ［(71.0±19.0) min vs. (112.6±26.8) min, t=-6.366, P=0.000］. The overall hospital stay was slightly longer for staged unilateral FURL than bilateral FURL ［(6.9±3.6) d vs. (8.4±2.1 )d, t=-1.674, P=0.101］. The fourweek postoperative SFR for bilateral FURL and staged unilateral FURL were 79.3% (23/29) and 80.0% (16/20), respectively (χ2=0.000, P=1.000). The overall complication rate was slightly higher for bilateral FURL ［20.7% (6/29) vs. 15.0% (3/20), χ2=0.017, P=0.896］.ConclusionSamesession bilateral flexible ureteroscopic holmium laser lithotripsy is a safe and effective treatment for bilateral upper urinary system stones in select patients.

参考文献/References:

[1]Sanguedolce F, Liatsikos E, Verze P, et al. Use of flexible ureteroscopy in the clinical practice for the treatment of renal stones: results from a large European survey conducted by the EAU Young Academic UrologistsWorking Party on Endourology and Urolithiasis. Urolithiasis,2014,42(4):329-334.
[2]那彦群，叶章群，孙颖浩，等主编.中国泌尿外科疾病诊断和治疗指南.北京：人民卫生出版社，2014.141-142.
[3]Breda A, Angerri O. Retrograde intrarenal surgery for kidney stones larger than 2.5 cm. Curr Opin Urol,2014,24(2):179-183.
[4]Kumar A, Vasudeva P, Nanda B, et al. A prospective randomized comparison between shock wave lithotripsy and flexible ureterorenoscopy for lower caliceal stones ≤2 cm: a singlecenter experience. J Endourol, 2015, 29(5):575-579.
[5]De S, Autorino R, Kim FJ, et al. Percutaneous nephrolithotomy versus retrograde intrarenal surgery: a systematic review and metaanalysis. Eur Urol,2015,67(1):125-137.
[6]杨波, 胡卫国, 胡浩, 等.逆行肾内手术治疗肾结石失败的原因分析及其对策.北京大学学报 (医学版),2014,46(5):794-797.
[7]朱世斌,李恭会,张志根.预留置输尿管支架管对首次输尿管软镜碎石术中放置工作鞘的影响.世界临床医学,2015,9（4）:59-60.
[8]Cepeda M, Amon JH, Mainez JA, et al. Flexible ureteroscopy for renal stones. Actas Urol Esp,2014,38(9):571-575.
[9]Torricelli FC, De S, Hinck B, et al. Flexible ureteroscopy with a ureteral access sheath: when to stent? Urology, 2014,83(2):278-281.
[10]Hollenbeck BK, Schuster TG, Faerber GJ, et al. Safety and efficacy of samesession bilateral ureteroscopy. J Endourol, 2003,17(10):881-885.
[11]Watson JM, Chang C, Pattaras JG, et al. Same session bilateral ureteroscopy is safe and efficacious. J Urol, 2011,185(1):170-174.
[12]Alkan E, Avci E, Ozkanli AO, et al. Samesession bilateral retrograde intrarenal surgery for upper urinary system stones: safety and efficacy.J Endourol,2014,28(7):757-762.
[13]Peng Y, Li L, Zhang W, et al. Singlestage bilateral versus unilateral retrograde intrarenal surgery for management of renal stones: a matchedpair analysis. J Endourol,2015,29(8):894-898.
[14]刘建河, 潘春武, 李瑞鹏, 等.输尿管软镜下钬激光碎石处理直径>2 cm 肾结石.中国微创外科杂志,2014,14(2):132-133.
[15]Ito H, Kuroda S, Kawahara T, et al. Preoperative factors predicting spontaneous clearance of residual stone fragments after flexible ureteroscopy. Int J Urol,2015,22(4):372-377.
[16]Jessen JP, Honeck P, Knoll T, et al. Flexible ureterorenoscopy for lower pole stones: influence of the collecting system’s anatomy. J Endourol,2014,28(2):146-151.

备注/Memo

备注/Memo:
﹡通讯作者，Email:ljianh@126.com
更新日期/Last Update: 2016-12-09