Objective: To evaluate the outcome of ureteroscopic pneumatic lithotripsy in single lower ureteric calculus and correlate its success with different CT parameters like HU, size of calculus and hydrnephrosis, if presen...Objective: To evaluate the outcome of ureteroscopic pneumatic lithotripsy in single lower ureteric calculus and correlate its success with different CT parameters like HU, size of calculus and hydrnephrosis, if present. Patients and Methods: This study was conducted from October 2017 to March 2019 in Department of General Surgery, Maulana Azad Medical College, New Delhi. 30 patients (out of which 6 were excluded due to spontaneous passage of calculus), with single lower ureteric calculus were chosen and the outcome of URSL was compared with respect to CT parameters of Size, HU and Hydronephrosis and intra-operative clearance of calculus. Results: Success rate of URSL in single lower ureteric calculus was found to be 75%. Lower HU (774.12 ± 212.85) was associated with higher success rate. Similarly smaller size of calculus (9 ± 2.1) mm was associated with success group. Patients with gross hydronephrosis had a poor outcome of URSL. Lower urinary tract infection (8.33%) was the most common complication. Conclusion: Patients with small size calculus, low HU and absence of hydronephrosis have a better outcome of URSL.展开更多
Objective: To assess the efficacy and safety of extracorporeal shock wave lithotripsy or pneumatic ureteroscopic lithotripsy for lower ureteral stones therapy, we sought to identify and summarize randomized controlled...Objective: To assess the efficacy and safety of extracorporeal shock wave lithotripsy or pneumatic ureteroscopic lithotripsy for lower ureteral stones therapy, we sought to identify and summarize randomized controlled trials that were used to treat distal ureteral stone. Methods: Eligible studies were identified from electronic databases. Database search, quality assessment, and data extraction were performed by two reviewers independently. Our primary outcome was the stone-free rate. Secondary outcomes were the fragmentation rate, complications and the rate of re-treatment and secondary procedures. The results were assessed by Review Manager 5.0. Publication bias was evaluated by Stata 11.0. Results: 13 trials were included. Meta-analysis of pooled data showed that pneumatic ureteroscopic lithotripsy demonstrated a significant advantage over extracorporeal shock wave lithotripsy (OR = 0.14, 95% CI [0.09, 0.23], P < 0.00001) in the stone-free rate;the extracorporeal shock wave lithotripsy had statistical disadvantages over pneumatic ureteroscopic lithotripsy in the fragmentation rate of ureteral stones (OR = 0.14, 95% CI [0.05, 0.39], P = 0.0002);and the rate of re-treatment and secondary procedure was lower in pneumatic ureteroscopic lithotripsy than in extracorporeal shock wave lithotripsy (OR = 5.37, 95% CI [2.61, 11.07], P < 0.00001). Our pooled results showed that there was no statistical difference between extracorporeal shock wave lithotripsy and pneumatic ureteroscopic lithotripsy in hematuresis, ureteral stricture and urosepsis or fever. Finally extracorporeal shock wave lithotripsy had a higher incidence of colic pain than pneumatic ureteroscopic lithotripsy. Conclusion: The present meta-analysis suggested that pneumatic ureteroscopic lithotripsy had large advantages over extracorporeal shock wave lithotripsy in the treatment of lower ureteral stones.展开更多
Objective: To investigate the effect of flexible ureteroscope lithotripsy and percutaneous nephrolithotomy on levels of serum inflammatory factors, oxidative stress and stress hormone in patients with renal calculi. M...Objective: To investigate the effect of flexible ureteroscope lithotripsy and percutaneous nephrolithotomy on levels of serum inflammatory factors, oxidative stress and stress hormone in patients with renal calculi. Methods: A total of 97 cases of renal calculi patients were chosen as the research objects, based on the random data table, they were divided into the control group (n=49) and the observation group (n=48), patients in the control group underwent percutaneous nephrolithotomy (PCNL) treatment, while the observation group patients were treated with flexible ureteroscope lithotripsy (FURL), before and after 1 d ,the levels of inflammatory factors [interleukin-10 (IL-10), C reactive protein (CRP), white blood cell (WBC)], stress hormone [cortisol (COR), adrenocorticotropic hormone (ACTH), norepinephrine (NE)] and oxidative stress [malondialdehyde (MDA), superoxide dismutase (SOD) ] of the two groups were compared. Results: There were no significant differences in IL-10, CRP, WBC, COR, ACTH, NE, MDA and SOD levels between the two groups preoperative;Compared with the preoperative level in the group, the 1 d post-operation levels of IL-10, CRP, WBC, COR, ACTH, NE and MDA in the two groups were significantly increased, and the level of the observation group was significantly lower than that in the control group;The levels of SOD in the two groups 1 d post-operation were significantly lower than those in the same group preoperative, and the control group (85.65±9.95) U/mL was significantly lower than that of the control group (94.71±7.63) U/mL. Conclusion: Compared with percutaneous nephrolithotomy, flexible ureteroscopic lithotripsy for renal calculi is less stressful and more favorable for postoperative recovery, has an important clinical value.展开更多
目的研究输尿管镜碎石术(URL)与经皮肾镜碎石术(PCNL)治疗输尿管上段复杂性结石的手术疗效及对C反应蛋白(CRP)、血红蛋白(Hb)水平的影响。方法选取我院2013年4月—2016年4月220例输尿管上段复杂性结石患者为研究对象,将纳入患者按随机...目的研究输尿管镜碎石术(URL)与经皮肾镜碎石术(PCNL)治疗输尿管上段复杂性结石的手术疗效及对C反应蛋白(CRP)、血红蛋白(Hb)水平的影响。方法选取我院2013年4月—2016年4月220例输尿管上段复杂性结石患者为研究对象,将纳入患者按随机数表法分为URL组与PCNL组,每组110例。URL组采用URL治疗,PCNL采用PCNL治疗,比较两组应激指标、血红蛋白、术中指标、结石清除率、术后恢复指标、术后并发症。结果URL组术后3 d CRP、Hb、术中出血量、住院时间分别为(20.20±6.54)mg/L、(119.43±19.21)g/L、(32.33±7.84)ml、(5.81±1.59)d与PCNL组的(23.15±6.29)mg/L、(104.39±21.81)g/L、(48.49±9.21)ml、(7.47±1.82)d比较差异有统计学意义(P<0.05)。PCNL组1次清石成功率、1个月内结石清除率分别为91.8%、96.4%显著高于URL组的79.1%、86.4%(P<0.05)。结论 PCNL较URL具有更佳清石效果,但可能造成较重手术创伤。应根据患者身体、经济、个人意愿等进行综合考量,选择合理手术方案。展开更多
文摘Objective: To evaluate the outcome of ureteroscopic pneumatic lithotripsy in single lower ureteric calculus and correlate its success with different CT parameters like HU, size of calculus and hydrnephrosis, if present. Patients and Methods: This study was conducted from October 2017 to March 2019 in Department of General Surgery, Maulana Azad Medical College, New Delhi. 30 patients (out of which 6 were excluded due to spontaneous passage of calculus), with single lower ureteric calculus were chosen and the outcome of URSL was compared with respect to CT parameters of Size, HU and Hydronephrosis and intra-operative clearance of calculus. Results: Success rate of URSL in single lower ureteric calculus was found to be 75%. Lower HU (774.12 ± 212.85) was associated with higher success rate. Similarly smaller size of calculus (9 ± 2.1) mm was associated with success group. Patients with gross hydronephrosis had a poor outcome of URSL. Lower urinary tract infection (8.33%) was the most common complication. Conclusion: Patients with small size calculus, low HU and absence of hydronephrosis have a better outcome of URSL.
文摘Objective: To assess the efficacy and safety of extracorporeal shock wave lithotripsy or pneumatic ureteroscopic lithotripsy for lower ureteral stones therapy, we sought to identify and summarize randomized controlled trials that were used to treat distal ureteral stone. Methods: Eligible studies were identified from electronic databases. Database search, quality assessment, and data extraction were performed by two reviewers independently. Our primary outcome was the stone-free rate. Secondary outcomes were the fragmentation rate, complications and the rate of re-treatment and secondary procedures. The results were assessed by Review Manager 5.0. Publication bias was evaluated by Stata 11.0. Results: 13 trials were included. Meta-analysis of pooled data showed that pneumatic ureteroscopic lithotripsy demonstrated a significant advantage over extracorporeal shock wave lithotripsy (OR = 0.14, 95% CI [0.09, 0.23], P < 0.00001) in the stone-free rate;the extracorporeal shock wave lithotripsy had statistical disadvantages over pneumatic ureteroscopic lithotripsy in the fragmentation rate of ureteral stones (OR = 0.14, 95% CI [0.05, 0.39], P = 0.0002);and the rate of re-treatment and secondary procedure was lower in pneumatic ureteroscopic lithotripsy than in extracorporeal shock wave lithotripsy (OR = 5.37, 95% CI [2.61, 11.07], P < 0.00001). Our pooled results showed that there was no statistical difference between extracorporeal shock wave lithotripsy and pneumatic ureteroscopic lithotripsy in hematuresis, ureteral stricture and urosepsis or fever. Finally extracorporeal shock wave lithotripsy had a higher incidence of colic pain than pneumatic ureteroscopic lithotripsy. Conclusion: The present meta-analysis suggested that pneumatic ureteroscopic lithotripsy had large advantages over extracorporeal shock wave lithotripsy in the treatment of lower ureteral stones.
文摘Objective: To investigate the effect of flexible ureteroscope lithotripsy and percutaneous nephrolithotomy on levels of serum inflammatory factors, oxidative stress and stress hormone in patients with renal calculi. Methods: A total of 97 cases of renal calculi patients were chosen as the research objects, based on the random data table, they were divided into the control group (n=49) and the observation group (n=48), patients in the control group underwent percutaneous nephrolithotomy (PCNL) treatment, while the observation group patients were treated with flexible ureteroscope lithotripsy (FURL), before and after 1 d ,the levels of inflammatory factors [interleukin-10 (IL-10), C reactive protein (CRP), white blood cell (WBC)], stress hormone [cortisol (COR), adrenocorticotropic hormone (ACTH), norepinephrine (NE)] and oxidative stress [malondialdehyde (MDA), superoxide dismutase (SOD) ] of the two groups were compared. Results: There were no significant differences in IL-10, CRP, WBC, COR, ACTH, NE, MDA and SOD levels between the two groups preoperative;Compared with the preoperative level in the group, the 1 d post-operation levels of IL-10, CRP, WBC, COR, ACTH, NE and MDA in the two groups were significantly increased, and the level of the observation group was significantly lower than that in the control group;The levels of SOD in the two groups 1 d post-operation were significantly lower than those in the same group preoperative, and the control group (85.65±9.95) U/mL was significantly lower than that of the control group (94.71±7.63) U/mL. Conclusion: Compared with percutaneous nephrolithotomy, flexible ureteroscopic lithotripsy for renal calculi is less stressful and more favorable for postoperative recovery, has an important clinical value.
文摘目的探讨输尿管软镜碎石取石术(flexible ureteroscopic lithotripsy,fURL)术前预置双J管对肾结石患者疗效的影响。方法回顾性分析2021年9月至2022年3月安徽医科大学第一附属医院收治的180例行fURL肾结石患者的临床资料。对照组(n=100)术前未预置输尿管支架,研究组(n=80)术前2周预置双J管。比较两组围手术期临床指标、视觉模拟评分法(visual analogue scale,VAS)、威斯康辛生活质量问卷(the Wisconsin Stone Quality of Life questionnaire,WISQOL)评分。结果对照组术后出现输尿管黏膜损伤3例,持续高热2例,研究组无并发症发生,对照组并发症发生率高于研究组,差异有统计学意义(P<0.05);对照组术前尿白细胞计数、初始尿培养阳性率、术前膀胱过度活动症(overactive bladder,OAB)发生率、一次输尿管通道鞘(ureteral access sheath,UAS)置入率均低于研究组,差异有统计学意义(P<0.05)。术后,对照组VAS评分低于研究组,WISQOL评分高于研究组,差异均有统计学意义(P<0.05);两组精力、睡眠、工作和家庭、对于出行和亲密行为的关注评分差值比较,差异无统计学意义(P>0.05);对照组营养和药物治疗、症状、总体情绪评分差值均高于研究组,差异有统计学意义(P<0.05)。结论术前预置双J管能够提高fURL中一次UAS置入成功率,但会降低患者生活质量,增加OAB和尿路感染发生率,且需承担额外的术前置双J管手术风险和费用。
文摘目的研究输尿管镜碎石术(URL)与经皮肾镜碎石术(PCNL)治疗输尿管上段复杂性结石的手术疗效及对C反应蛋白(CRP)、血红蛋白(Hb)水平的影响。方法选取我院2013年4月—2016年4月220例输尿管上段复杂性结石患者为研究对象,将纳入患者按随机数表法分为URL组与PCNL组,每组110例。URL组采用URL治疗,PCNL采用PCNL治疗,比较两组应激指标、血红蛋白、术中指标、结石清除率、术后恢复指标、术后并发症。结果URL组术后3 d CRP、Hb、术中出血量、住院时间分别为(20.20±6.54)mg/L、(119.43±19.21)g/L、(32.33±7.84)ml、(5.81±1.59)d与PCNL组的(23.15±6.29)mg/L、(104.39±21.81)g/L、(48.49±9.21)ml、(7.47±1.82)d比较差异有统计学意义(P<0.05)。PCNL组1次清石成功率、1个月内结石清除率分别为91.8%、96.4%显著高于URL组的79.1%、86.4%(P<0.05)。结论 PCNL较URL具有更佳清石效果,但可能造成较重手术创伤。应根据患者身体、经济、个人意愿等进行综合考量,选择合理手术方案。
