微创手术治疗体外震波无效的输尿管上段结石疗效比较

Therapeutic effect of minimally invasive surgery in treating upper ureteral calculi after failed ESWL

目的探讨体外震波(ESWL)处理输尿管上段结石无效后经逆行输尿管镜(URL)、微创经皮肾镜碎石(MPCNL)或后腹腔镜下输尿管切开取石(RLU)治疗的有效性、安全性。方法回顾性分析2008年1月至2012年1月该院采用3种微创方式治疗180例ESWL无效的输尿管上段结石患者的资料,比较3种微创治疗术式的结石清除率。结果 URL一次治疗成功率71%,MPCNL与RLU为100%。URL术后1个月结石清除率为86%。结论 MPCNL与RLU结石清除率高,URL结石清除率较低但手术时间短,需要根据情况选择治疗方式。

Objective To evaluate the clinical efficacy of three minimally invasive surgical approaches （URL,MPCNL and RLU） for treatment ESWL-failed upper ureteral stones. Methods A retrospective analysis was performed in 180 upper ureteral calculi pa- tients treated with those above methods in our hospital from January 2008 to January 2012. The stone-free rate was considered as an indicator for comparing. Results The stone-free rate of URL, MPCNL and RLU were 71%, 100% and 100%, respectively. The stone-free rate of URL one month after operation was 86%. Conclusion Compared to the URL,the MPCNL and RLU have higher clearance of calculi. However,URL has the shorter operation time. The choice of treatment should be according to patients＇ condition.