Comparison Of Holmium Laser Lithotripsy And Penumatic Lithotripsy In Therapeutic Effect Of Ureteral Calculi

Objective and Background:Ureteral calculi is a common disease in urinary tract diseases, because ureteral calculi always can lead to ureter obstruction, and then lead to hydronephrosis and kidney damage, It needs active and effective treatment. Ureteroscope lithotripsy is an important way to treat ureteral stone, the current popular technologies are pneumatic lithotripsy (PL) and holmium laser(HL). But PL has some shortcomings. For example, it is easy to cause the stone to move to calyx, it can not be used in soft lenses and can not cure polyps. Since the mid-90s of the 20th century, holmium laser technology emerged and was used in the treatment of urinary stones. Since it.can deal with polyps, and not easy to cause the stone move, it has been used in clinical gradually. Holmium laser machine was first introduced to our hospital in April 2009, and used in the treatment of ureteral stones, this procedure was associated with a good outcome in our series. In this article we compare the therapeutic effect and safety of holmium laser lithotripsy (HL) with penumatic lithotripsy (PL) on the treatment of ureteral calculi, and summarize the clinical experience of ureteroscopic holmium laser lithotripsy. Materials and Methods:Clinical data of HL (44 cases) and PL (103cases) was collected from January 2008 to March 2009 and compared with statistical analysis in the stone success rate and complications, in order to know the safety and efficacy of holmium laser lithotripsy.Results:The average operation time was 45min, the average postoperative hospital stay was 3.5d in HL group, and 39min,3.6d in PL group. The success rate was reached 88.64% in HL and 81.55% in PL. In the proximal ureteral calculi patients, stones free rate was 100% in HL which is significantly increased compared with 84.21% in PL (p<0.01). in the middle and distal ureteral calculi, there is no significant differences in stones free rate between HL(96.55%) and PL (95.16%) (p>0.05) HL group 1 case had ureteral perforation, converted to open surgery, and there were 3 cases had ureteral perforation in PL group,1 case converted to open surgery, two cases of indwelling ureteral stents. No serious complication such as ureteral tear occurred in HL group and PL group. HL group had 4 cases with polypi, all to be cauterized.Conclusion:HL is a highly effective and safe method for managing ureteral calculi, especially for patients with polyps of the ureter stone.