Holmium laser percutaneous nephrolithotomy for treating upper ureteral callui: Report of 132 cases / 中国微创外科杂志

ABSTRACT

Objective To explore the safety and efficiency of holmium laser percutaneous nephrolithotomy in the treatment of upper ureteral calcui.Methods A retrospective analysis was made on 132 cases of upper ureteral calcui treated by holmium laser percutaneous nephrolithotomy.After retrograde placement of the ureteral catheter,a track from the skin surface into the middle renal calyx was established under the guidance of a C-arm fluoroscopy.Then a ureteroscope was passed to introduce a holmium laser lithotriptor.Stones were broken up and a nephrostomy tube was placed in the incision to carry fluid from the kidney.Results Holmium laser percutaneous nephrolithotomy was completed on one session in all the 132 cases(155 sides),including 116 cases of single-tract nephrolithotomy and 16 cases of double-tract nephrolithotomy.The stone-free rate was 95.5%(148/155).The duration of operation was 30~320 min(mean,108 min).The intraoperative blood loss was 50~200 ml(mean,100 ml).No blood transfusion was required and no postoperative hemorrhage happened.No analgesics were needed after operation.The nephrostomy tube was left for 3~8 d(4.6 d).The length of postoperative hospital stay was 5~11 d(mean,7.4 d).Follow-up observations in the 132 cases for 1~6 months(mean,3 months) showed complete relief of symptoms.B-ultrasonography showed a mean of renal pelvis separation of 15 mm,which had decreased by 9~28 mm postoperatively.Conclusions Holmium laser percutaneous nephrolithotomy is safe and effective in the treatment of upper ureteral calcui.