Influential factors of Ho:YAG laser lithotripsy in management of ureteral calculi / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the clinical effect of Ho:YAG laser lithotripsy in management of ureteral calculi and to investigate its influential factors. Methods The data of 137 cases of ureteral calculi (66 males and 71 females;aged 19-71 years with a mean of [(45.0?10.4)years;disease course from 4 days to 10 years with a mean of (1.50?0.65)years] treated via ureteroscope with Ho:YAG laser lithotripsy were analyzed retrospectively.Of them 112 cases had 1 stone,and 25 had more than one.Fifty five cases had stones on the left side,71,on the right side;11,on both sides;107 cases had stones in the lower ureter and 30,in the middle or upper ureter.The size of the stones were 0.6-2.0 cm in diameter with a mean of ( 1.1? 0.3) cm.Of them 23 cases had ureteral polyp and they underwent Ho:YAG laser vaporization resection of the polyp;11 cases had ureteral stricture and they underwent ureter dilatation or Ho:YAG laser incision of the stricture and lithotripsy.Double J tube was placed after operation. Results The overall stone fragmentation rate was 94.9%(130/137) with a single procedure.Stone free time was 5-56 d with a mean of ( 21.5 ?13.4) d.Operating time was (20-120)min with a mean of (60.4?18.3)min.Post operative hospital stay was 1～10 d with a mean of (2.4?1.1)d.In the successful operation group (130/137),the mean stone size was (1.03?0.24)cm in diameter, while in the failure group it was (1.47?0.51) cm. Four cases of the failure group had ureteral stricture;2 of them underwent shift to open operation, the other 2 experienced failure because of difficulty of placing D J tube. Three cases also experienced failure because of stone shift in the operation;of them 1 underwent shift to open operation,the other 2 were treated by ESWL.The differences of the stone size,concomitant ureteral stricture, stone shift in operation between success group and failure group were statistically significant ( P