ABSTRACT
Objective To compare the outcomes of antegrade and retrograde approach ureteroscopy for impacted upper ureteric calculi and assess the safety and efficiency of the two types of minimally invasive technique. Methods A total of 106 patients with impacted upper ureteric calculi were treated with ureteroscopy. The procedure was performed via antegrade percutaneous nephrostomy tract in 50 patients (antegrade group) and via retrograde transurethral access in 56 patients (retrograde group). Results The success rate of retrograde group was 92.9% (52/56). Operating time was (45 ± 5 ) min, hospital stay was (6 ± 1) days. The stone free rate was 80.4%(45/56) at 1 month follow-up,7 patients with residual calculi required ESWL combination. Complication rate was 5.4% (3/56). The success rate of antegrade group was 100.0% (50/50). Operating time was (55 ± 8 ) min, hospital stay was (8 ± 2) days. The stone free rate was 100.0% (50/50) and no complication was noted. The stone free rate and the complication rate indicated significant difference between the two groups (P ＜ 0.05). Conclusions Antegrade and retrograde access ureteroscopy for impacted upper ureteric calculi are safe and effective. Success rate and stone free rate of antegrade approach are higher than those of retrograde approach.
ABSTRACT
Objective:Both URL and MPCNL have been widely applied in the treatment of ureteral calculi.In this study,the safety,efficiency and degree of injury were compared between retrograde and antegrade access ureterolithotripsy for the calculi complicated with infection,in order to clarify the indications of the two types of minimally invasive techniques.Methods:A total of 192 patients with upper ureteral calculi complicated with infection were treated with ureterolithotripsy.The operation was performed via retrograde transurethral access in 72 patients and via antegrade percutaneous nephrostomy tract in 120 patients.Results:The success rate of retrograde approach was 93.1%.Mean operating time was 45.9?16.5min(20-90 min) with mean hospital stay of 5.1?1.8(2-6) days.The stone free rate was 84.7%(61/72) at 1 month follow-up.5 patients with residual calculi required combined ESWL.Complications were noted in 5.6%,CRP was 10.59?5.12 mg/L before operation,and was 38.63?4.61 mg/L 24h after the operation.The success rate of antegrade approach was 99.2%.Mean operating time was 62.4?17.6 min(40-120 min) with mean hospital stay of 8.57?2.57(5-15) days.The stone free rate was 100% and 1 complication was noted(0.01%).CRP was 11.29?5.38 mg/L before the operation,34.93?7.82 mg/L 24h after the operation.For the success rate and stone free rate,antegrade approach was higher than retrograde approach(P0.05)between the two groups before operation,but antegrade approach had lower CRP(P