Comparison Of The Efficacy Of Ureteroscopic Holmium Laser And Cold Knife Incision For Ureteral Stricture

Objective:With the development of minimally invasive techniques in the lumen,ureteroscopic ureteral stricture incision is widely used to treat ureteral stricture,there are few comparative studies on the efficacy of the two surgical methods.This study was designed to compare the effects of ureteroscopic holmium laser and cold incision in the treatment of ureteral stricture.Methods:Collecting data of 78 patients with ureteral stricture incision performed by the same surgeon from January 2010 to December 2016 in our hospital.The patients who underwent ureteroscopic holmium laser incision were enrolled in the holmium laser group,a total of 40 cases;The patients who underwent ureteroscopic cold knife incision were treated with cold knife group,a total of 38 cases.Statistical methods were used to analyze the operation time,postoperative hospital stay,postoperative infection rate,collection system separation and glomerular filtration rate(GFR)and incidence of surgical complications.To compare the clinical efficacy of two surgical methods in the treatment of ureteral stricture.Results:None of the patients in the holmium laser group underwent open surgery.There were no serious complications such as damage to organs and large blood vessels.No serious complications such as ureteral avulsion occurred.All patients had mild hematuria and no hemostatic drugs were used.After 1 to 2 days,hematuria disappeared by itself.In the cold knife group,2 patients underwent open surgery,including 1 case of ureteral avulsion and 1 case of massive hemorrhage caused by vascular injury.Patients who successfully completed the cold knife incision treatment had moderate hematuria after surgery,and the hematuria disappeared after 2 to 3 days of application of hemostatic drugs.39 patients in the holmium laser group were interviewed,and 33 patients in the cold knife group were interviewed.The collection system separation and GFR were significantly improved in the two groups.The difference was statistically significant(P<0.05),but the degree of recovery was not statistically significant(P>0.05).The operation time of holmium laser group [(36.2±5.4)min],postoperative hospital stay [(4.0±0.9)d],postoperative infection rate(7.7%),and cure rate(87.2%)were significantly better than cold knife group [(42.8±7.0)min,(5.4±1.2)d,27.3%,57.6%],the difference was statistically significant(P<0.05).Conclusion:The clinical efficacy of ureteroscopic holmium laser incision for ureteral stricture is superior to that of cold knife incision.It has the advantages of precise cutting,low recurrence rate,less complications,quick recovery,and easy operation and repeated operation.