Ureteroscopic holmium laser incision versus ureteroscopic cold knife incision in the treatment of ureteral stricture / 医学研究生学报

ABSTRACT

Objective　The aim of this study was to compared the clinical effect of ureteroscopic holmium laser incision (USHLI) with that of ureteroscopic cold knife incision (USCKI) in the treatment of ureteral stricture.　Methods　Seventy-eight patients with ureteral stricture underwent USHLI (n = 40) or USCKI (n = 38) in the Armed Police Corps Hospital of Jiangsu Province from January 2010 to December 2016. Comparisons were made between the two surgical strategies in the operation time, postoperative complications, hospital days, short-term effect and long-term effect.Results　Mild postoperative hematuria occurred in all the patients of the USHLI group, which lasted 1-2 days before it disappeared without intervention, but with no other severe complications as adjacent organ injury, ureteral avulsion, or massive hemorrhage. Moderate postoperative hematuria was observed in all the patients of the USCKI group, which was stopped at 2-3 days by administration of hemostatics. Compared with USCKI, USHLI achieved a significantly shorter operation time ([43.4 ± 5.8] vs [35.3 ± 3.8] min, P < 0.05) and postoperative hospital stay ([5.0 ± 1.4] vs [4.0 ± 0.8] d, P < 0.05), lower incidence of postoperative infection (27.3% vs 7.7%, P < 0.05), and higher cure rate (57.6% vs 87.2%, P < 0.05).　Conclusion　USHLI, with its advantages of less damage, lower recurrence rate and fewer complications, is obviously superior to USCKI in the treatment of ureteral stricture.