输尿管软镜处理大于3 cm肾结石的有效性和安全性评价

Evaluation of the efficacy and safety of flexible ureterorenoscopy in the treatment of renal calculi larger than 3 cm

目的探讨应用输尿管软镜(flexible ureterorenoscopy,FURS)处理直径>3 cm肾结石的有效性和安全性。方法回顾性分析2017年1月至2021年1月采用FURS下激光碎石取石术治疗直径>3 cm肾结石52例,其中单侧肾结石42例、双侧肾结石10例;下盏铸形结石24例、鹿角形结石5例,结石直径3.2~6.0 cm。所有患者均预留置单侧或双侧输尿管支架管至少10 d后行FURS手术。术后1 d及术后4周时行影像学(KUB)复查,评估碎石后效果。结果52例患者单次手术成功率100%,手术时间60~305 min,平均135.4 min;术后无发热,无严重并发症,术后1 d复查结石清除率86.5%,术后1个月复查结石清除率100%。结论对于熟练掌握FURS的中心,FURS单次手术治疗直径>3 cm的肾结石是一种相对安全、有效的临床方法。

Objective To explore the feasibility and safety of flexible ureterorenoscopy(FURS)in the treatment of renal calculi larger than 3 cm and the surgical techniques in clinical practice.Methods 52 cases of kidney stones larger than 3 cm in diameter were treated with FURS,including 42 cases of unilateral kidney calculi,10 cases of bilateral kidney calculi,24 cases of lower calyceal cast calculi,5 cases of renal pelvis cast calculi with a stone diameter of 3.2-6.0 cm.FURS was performed in all patients after 10 days of unilateral or bilateral ureteral stent indwelling.KUB was performed on the first day and fourth week after operation to evaluate the effect of lithotripsy.Results The single operation success rate of 52 patients was 100%,the operation time was 60-305 min,and the average time was 135.4 min.there was no fever and serious complications after operation.The calculi clearance rate was 86.5%on the first day after operation,and 100%one month after operation.Conclusions For centers skilled in Furs,FURS is a relatively safe and effective clinical method for the treatment of kidney calculi larger than 3 cm.