Evaluation of ureterorenoscopy with semirigid ureteroscope and laser lithotripsy as a treatment modality for upper ureteric stones less than 20 mm

R. Batra, P. Batra, Shreyak Garg, S. Yadav
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Abstract

Context: Technological developments over the past two decades have revolutionized the treatment of ureteric stones. With the emergence of flexible, small-diameter ureteroscopy, the paradigm of ureteral stone treatment has shifted to ureteroscopy. The success rate is close to 95%, but it has its own complications. Objective: The objective of this study is to assess the effectiveness of ureterorenoscopy (URS) with semirigid ureteroscope and laser lithotripsy in the treatment of upper ureteric stones of size less than 20 mm and its associated complications. Methods: This is a prospective cohort study designed to assess the effectiveness of URS for the treatment of upper ureteric calculi. We present data from 57 patients who received URS as their primary treatment at our center and were followed up for at least 3 months. Results: We found that when stone size was less than 10 mm, the stone-free rate was 80% (28/35), while when stone size was in the 10.1–20 mm range, the stone-free rate increased to 90.9% (20/22). Stones were found in 41/48 patients (85.41%) with symptoms lasting less than a month. Only 7/9 patients (77.77%) were stone-free in the group with symptoms lasting more than a month. A total of 28.1% of patients encountered complications among which proximal migration of the stone was the most common (12.3%). Mean procedure time was 40.37 min. Conclusion: This study shows that URS had a higher stone-free rate when treating stones of size ranging from 10.1 to 20 mm. In upper ureteric stones ranging in size from 10.1 to 20 mm, we strongly advise using URS as the primary treatment option.
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输尿管镜下半硬输尿管镜联合激光碎石治疗输尿管上段小于20mm结石的疗效评价
背景:过去二十年的技术发展已经彻底改变了输尿管结石的治疗。随着柔性、小直径输尿管镜的出现,输尿管结石的治疗模式已转向输尿管镜。成功率接近95%,但它也有自己的并发症。目的:探讨输尿管镜联合半硬输尿管镜联合激光碎石术治疗输尿管上段小于20mm结石及其并发症的疗效。方法:这是一项前瞻性队列研究,旨在评估URS治疗输尿管上段结石的有效性。我们提供了来自57名在我们中心接受URS作为主要治疗的患者的数据,并随访了至少3个月。结果:我们发现,当石材尺寸小于10 mm时,石材的游离率为80%(28/35),而当石材尺寸在10.1-20 mm范围内时,石材的游离率增加到90.9%(20/22)。48例患者中有41例(85.41%)出现结石,症状持续时间小于1个月。在症状持续1个月以上的患者中,仅有7/9(77.77%)无结石。共有28.1%的患者出现并发症,其中结石近端移位最为常见(12.3%)。平均手术时间为40.37分钟。结论:本研究表明,在治疗10.1 - 20 mm的结石时,URS的结石清除率更高。对于输尿管上部结石,大小从10.1到20毫米,我们强烈建议使用尿路作为主要治疗选择。
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