Flexible Ureteroscopy Combined With Holmium Laser Lithotripsy For Renal Stones2cm Or Greater

Objective:To evaluate the efficacy, safety of flexible ureteroscopy combined with holmium laser lithotripsy for treatment of renal stones2cm or greater.Methods:A sum of30patients received flexible ureteroscopy combined with holmium laser lithotripsy in Sir Run Run hospital from June2010to August2012. Among the cases, the calculi were located at the renal pelvis in16patients, at the lower calyx in5, at the middle calyx in4, and at the upper calyx in1. The other4cases were staghorn stone. Mean stone size was2.9cm (ranged from2.2cm-5.0cm). The number of procedures, operative time, time of discharge after operation, preoperative and postoperative hemoglobin concentrations, stone-free rate, stone compostions, and preoperative complications were evaluated.Results:All stones were successfully detected. The average duration of operation was72 min(ranged from55-100min). The mean number of procedures was1.2(range1to3).25patients required only1procedure,4required2treatments and1required3treatments. The patients were discharged from hospital in2-4days(mean time2.2days) after operation. After1,2and3procedures,65,85and90%of patients were stone free, respectively. There were3minor complications, including1emergency room visit for pain, and1case of fever and a case of gross hematuria. No blood transfusions were required, no severe complications were identified.Conclusion:Flexible ureteroscopy combined with holmium laser lithotripsy is an effective and safe choice for renal stones2cm or greater.