Holmium Laser for the Treatment of Upper Urinary Tract Diseases:Report of 101 Cases / 中国微创外科杂志

ABSTRACT

Objective To investigate the efficacy of Holmium laser for upper urinary tract diseases.Methods A total of 101 patients with urinary tract stricture or calculus in the lower or middle ureter were treated with holmium laser by ureteroscopy from January 2005 to June 2007 in our hospital.For the patients with stones in the upper urinary tract or the kidney,percutaneous nephrolithotripsy(PNL) with holmium laser by ureteroscopy was performed.Results No patients developed perforation,urinary leakage,or infection after the operation.In the 23 cases of ureteral stricture,6 were cured,10 were improved,5 were failed,and 2 were deteriorated or even developed hydronephrosis.The two who were deteriorated after the operation was converted to open surgery because of pain in the kidney area and refractory infection.They were cured after resection of the strictured segment and end-to-end anastomosis.Follow-up was available for 3 to 24 months(mean,12 months);none of the patients had recurrence during the period.In the 40 patients with lower or middle ureteral stones,nephrolithotripsy was completed successfully in all but 7,in whom the stones moved into the kidney during the procedure.These 7 patients were then cured by extracorporeal shock wave lithotripsy.The 40 patients were followed up for 3 to 18 months(mean,15),none of them had recurrence.In the 24 cases of upper urinary tract stones and 14 patients with renal calculus,the stones were removed completely by the first PNL in 36;2 patients received a second operation after indwelling renal cannula for 1 week because of intraoperative hemorrhage.These 38 patients achieved a follow-up of 3 to 24 months(mean,18),no one of them showed residual stones,or recurrent calculus or stricture of the ureter.Conclusions Holmium laser by ureteroscopy is safe,effective,and minimally invasive for patients with upper urinary tract disorders.The treatment is worth being used thanks to a low rate of intra-and postoperative complications.