Minimally invasive percutaneous nephrolithotomy in treatment of superior segment ureter calculi / 国际外科学杂志

ABSTRACT

Objective To evaluate mini-percutaneous nephrolithotomy in treating superior segmental ureteral calculi. Methods Two Hundred and thirty-six patients underwent mini-percutaneous nephrolithotomy with holmium laser for superior segmental ureteral calculi from May 2005 to May 2008, 133 male and 103 female. Their age ranged from 17 to 76 years old with a mean of 47. 2 years. Of the 236 patients,141 compli-cated with calculi in the left side and 88 cases in the right side,7 in the both sides. The calculi diameter ranged from 0. 7 cm to 2.2 cm and the mean diameter was 1.4 cm. One hundred and ninety-three patients had undergone ESWL from 1～6 times. Results Of the 236 patients,217 were rendered stone-free at 1 pro-cedure. Residual calculi were found in 12 cases after operation and drugs were used for treatment. The resid-ual calculi were removed after 1 month. Seven cases with residual calculi were treated by ESWL and the cal-culi were removed. The total stone clearance was 91.9%. The mean operation time was 31.3 min(rang from 19～52 min), and the mean hospital stay was 9.5 days(rang from 6 to 12 days). The main complications following operation included durative hematuria in 25 cases relieved by haemostasis and diuresis treatment within 24 to 48 hours,pnstoperative fever in 141 cases within 24 hours of which 103 were relieved by antiin-flammatory and fluid replacement treatment within 24 to 48 hours. Thirty-eight cases were relieved by anti-inflammatory treatwent depending on urine culture results within 3 to 7 days. The postoperative pain in all patients was light. Conclusion Minimally invasive percutaneous nephrolithotomy with holmium laser under ultrasound guidance is simple,safe and effective in treating proximal ureteral calculi.