Ureterscopic Holmium:YAG Laser Lithotripsy For The Treatment Of Upper Ureteral Calculi

Objective To eveluate the efficacy and safety of the ureteroscopic holmium laser lithotripsy for the upper ureteral calculi, explore the relevant factors affecting the success of the operation, operating techniques and complications preventions.Method Collection of clinical data of135cases who underwent ureteroscopic holmium YAG laser lithotripsy of single site upper ureteral calculi in Sir Run run shaw hospital of medical school of zhejiang university between october2009to october2011, retrospective analyzed and compared the success of lithotripsy with gender, age,stone side, stone size, preoperative ESWL treatment history, affiliated with ureteral polypus, ureteral stricture or twist, the degree of hydronephrosis, preoperative renal function, etc;Observe and analyzed during and post-operative complications.Result135patients in this group,the122cases success with a single procedure, the success rate was90.4%(122/135),after four weeks follow-up the stone free rate was92.6%(113/122); Analysis showed that the factors of gender, age, stone side,preoperative ESWL treatmen history, preoperative renal function etc are not related to the success of lithotripsy(p>0.05), but stone size, ureteral stricture (or) twist, affiliated with ureteral polypus, the degree of hydronephrosis is related to success of lithotripsy (p<0.05). The incidence of complications is4.4%. Three cases of severe bleeding, two cases of ureteral perforation, one case with septic shock.Conclusion Ureteroscopic Holmium laser lithotripsy for upper ureteral calculi is safe and effective method. The key to successful operation is to select the appropriate cases.the factor of gender, age, stone side, preoperative ESWL treatmen history, preoperative renal function etc are not related to the success of lithotripsy; stone size, ureteral stricture (or) twist, affiliated with ureteral polypus, the degree of hydronephrosis etc are related to success of lithotripsy. Complication rate can be reduced by improving the operating skills。...