Minimally invasive management for upper ureteral calculi: Report of 258 cases / 中国微创外科杂志

ABSTRACT

Objective To evaluate clinical effects of the transurethral ureteroscopic lithotripsy(URL) and minimally invasive percutaneous nephrolithotomy(MPCNL) in the management of upper ureteral stones.Methods Clinical data of 258 patients diagnosed as having upper ureteral calculi from January 2001 to December 2004 in this hospital were retrospectively analyzed.The patients were given either URL(225 patients) or MPCNL(33 patients).Results Of the URL,the stone-free rate on one session was 73.8%(166/225) and the failure rate was 26.2%(59/225).The causes for the failure included stone movement to the renal pelvic in 42 patients(18.7%,42/225),unsuccessful manipulation in 14 patients(6.2%,14/225),and conversions to open surgery because of ureteral perforation in 1 patient and ureteral rupture in 2 patients(1.3%,3/225).Of the MPCNL,the stone-free rate on one session was 100%(33/33).Conclusions The application of URL can be interfered with ureteral stricture and twist that are secondary to incarcerated ureteral stones.High stone-free rate,low incidence of complications,and satisfactory reliability can be expected using MPCNL,especially in patients with impacted ureteral calculi accompanied with secondary affection at the same side.