同期双侧输尿管软镜碎石术治疗双侧≤1.5cm肾结石疗效分析

Analysis of curative effect of simultaneous bilateral flexible ureteroscopic lithotripsy for bilateral renal calculi smaller than 1.5 cm

目的:评价同期双侧输尿管软镜碎石术(SB-FURL)治疗双侧≤1.5cm肾结石的有效性及安全性。方法:回顾性分析71例双侧≤1.5cm肾结石的患者的临床资料,均采用SB-FURL治疗,结石最大径(11.8±2.3)mm。评估手术时间、结石清除率(SFR)、术后并发症发生率和重复治疗率。结果:71例患者平均手术时间为(55.3±25.7)min,住院天数为(2.4±2.1)d。一次SB-FURL术后SFR为73.2%(52/71),5例(7%)接受了≥2次的治疗。71例共行逆行软性输尿管镜下钬激光碎石术77次,平均1.08次/人。术后3个月总SFR为88.7%(63/71),总并发症发生率为12.6%(9/71),其中输尿管假道形成1例,输尿管穿孔并肾周血肿1例,术后发热6例(8.4%)。结论:SB-FURL治疗双侧≤1.5cm肾结石是安全有效的,值得临床推广和应用。

Objective:To analyze the safety and efficacy of simultaneous bilateral flexible ureteroscopic lithotripsy(SB-FURL)for bilateral renal calculi smaller than 1.5 cm.Method:Clinical data of 71 patients who underwent SB-FURL for treatment of bilateral renal calculi smaller than 1.5 cm were retrospectively analyzed.The maximum diameter of stone was(11.8±2.3)mm.The clinical data included operation time,stone clearance rate,retreatment rate and occurrence of complications.Result:Out of the 71 patients,their mean operative time and postoperative hospital stay were(55.3±25.7)min and(2.4±2.1)d.The stone free rate was 73.2%(52/71)after single procedure,which increased to 88.7%(63/71)via retreatments after 3 months.The retreatment rate was 7%(5/71),with total of 77 FURL procedures performed and 1.08 times per patient.The occurrence of complications was 12.6%.One case had false passage of ureter orifice causing slight ureteral wall injury.Ureteral perforation with perirenal hematoma was in 1 case.Overall postoperative fever rate was 8.4%(6/71).Conclusion:SB-FURL is safe and effective in the treatment of bilateral renal calculi smaller than 1.5 cm.