Objective:To analyze the effect of Shiwei Powder combined with stone composition analysis on stone removal efficiency and complication rates after ureteroscopic holmium laser lithotripsy(FURL).Methods:Ninety six patie...Objective:To analyze the effect of Shiwei Powder combined with stone composition analysis on stone removal efficiency and complication rates after ureteroscopic holmium laser lithotripsy(FURL).Methods:Ninety six patients with FURL admitted to the hospital from March 2023 to March 2025 were selected and randomly divided into two groups.The observation group was treated with FURL combined with Shiwei Powder,while the control group was treated with FURL monotherapy.Based on the stone composition of the two groups,the stone removal efficiency,complication rates,recurrence rates,TCM syndrome scores,and inflammatory factor levels were compared.Results:The stone removal efficiency of the observation group was higher than that of the control group.The stone composition was mainly calcium oxalate monohydrate and composite stones containing calcium oxalate monohydrate.The incidence of postoperative complications was lower in the observation group than in the control group(P<0.05).After 3–6 months of follow-up,the recurrence rate in the observation group was lower than that in the control group(P<0.05).After treatment,the TCM syndrome scores and inflammatory factor levels in the observation group were lower than those in the control group(P<0.05).Conclusion:Based on the results of urinary stone composition analysis,patients treated with Shiwei Powder after FURL have higher stone removal efficiency.The most significant effect is observed in urinary stones composed of calcium oxalate monohydrate and composite stones containing calcium oxalate monohydrate.This treatment can improve stone removal,prevent complications,reduce recurrences,effectively improve disease symptoms,and reduce inflammation.展开更多
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
BACKGROUND Drainage tube removal is difficult when the greater omentum becomes incarcerated in the drainage tube through the side holes.Currently,known removal methods are either ineffective or will cause additional d...BACKGROUND Drainage tube removal is difficult when the greater omentum becomes incarcerated in the drainage tube through the side holes.Currently,known removal methods are either ineffective or will cause additional damage to the patient in a secondary operation.Ureteroscopy and the holmium laser have been used in various surgical techniques in urology,and in theory,they are expected to be a good strategy for solving the problem of tissue incarceration.CASE SUMMARY Four patients diagnosed with difficult removal of an abdominal drainage tube following abdominal surgery are reported.All patients underwent surgery to remove the incarcerated greater omentum in the drainage tube using a holmium laser and a ureteroscope,and a new 16-F drain was then placed in the abdominal or pelvic cavity.The efficacy of this technique was evaluated by intraoperative conditions,success rate,and operating time;safety was evaluated by perioperative conditions and the probability of postoperative complications.All four operations went smoothly,and the drains were successfully removed in all patients.The average operating time was 24.5 min.Intraoperatively,the average irrigation volume was 892.0 mL,the average drainage volume was 638.5 mL,and no bleeding or damage to surrounding tissues was observed.Postoperatively,the average drainage volume was 32.8 mL and the new drains were removed within 36 h.All patients were able to get out of bed and move around within 12 h.Their visual analogue pain scores were all below 3.The average follow-up duration was 12.5 mo and no complications such as fever or bleeding were noted.CONCLUSION Ureteroscopic holmium laser surgery is an effective,safe and minimally invasive technique for removing drains where the greater omentum is incarcerated in the abdominal drain.展开更多
Objective: to analyze the operation and nursing methods of ureteroscopic pneumatic lithotripsy for urethral calculi. Methods: a total of 120 patients who were treated for urethral calculi in our hospital in 2021 were ...Objective: to analyze the operation and nursing methods of ureteroscopic pneumatic lithotripsy for urethral calculi. Methods: a total of 120 patients who were treated for urethral calculi in our hospital in 2021 were randomly divided into observation group and control group, with 60 patients in each group. Both groups of patients will be treated with pneumatic lithotripsy under ureteroscope after entering our hospital. Patients in the observation group will receive comprehensive care, while those in the control group will receive general care. After the treatment, the operation, nursing satisfaction, postoperative complications and hospitalization of the two groups were compared. Results: the observation group showed more advantages in operation and nursing satisfaction. Conclusion: patients suffering from urethral calculi and receiving pneumatic lithotripsy under ureteroscope should use more advanced comprehensive care and the final treatment effect will be better, which is worth popularizing.展开更多
Objective: to analyze and study the nursing methods and nursing effects of patients with upper urinary tract stones after treatment with ureteroscopic holmium laser lithotripsy. Methods: the study began in January 202...Objective: to analyze and study the nursing methods and nursing effects of patients with upper urinary tract stones after treatment with ureteroscopic holmium laser lithotripsy. Methods: the study began in January 2020 and ended in November 2021. Forty-eight patients who came to the hospital for treatment during the study period were selected as the research objects. All of them were hospitalized for upper urinary tract stones. They were divided into two different groups by random drawing of lots. They were named as the contrast group and the observation group, with 24 patients in each group. Holmium laser lithotripsy with flexible ureteroscope was used as the treatment between the two groups. The former received surgical treatment while carrying out routine care, while the latter carried out comprehensive care. The nursing effect between the groups was compared and analyzed. Results: compared with the two groups, the operation index of the observation group was better (p < 0.05). The clinical indexes of the observation group improved more (P < 0.05). The observation group had a relatively lower incidence of complications and higher nursing satisfaction (P < 0.05). In terms of quality of life, the observation group improved better (P < 0.05). Conclusion: in the process of implementing ureteroscopic holmium laser lithotripsy for patients with upper urinary tract calculi, combined with comprehensive nursing intervention can produce a relatively ideal intervention effect, which is suitable for universal use.展开更多
Background:The use of tamsulosin before semirigid ureteroscopy(URS)for proximal ureteral stones increases operative success.Several authors have usedα-blockers for dilation of the ureter,andmost studies have observed...Background:The use of tamsulosin before semirigid ureteroscopy(URS)for proximal ureteral stones increases operative success.Several authors have usedα-blockers for dilation of the ureter,andmost studies have observed a higher stone-free rate and fewer complications than those with a placebo or no use of drugs.Ureteroscopy is the standard treatment for ureteral stones and has excellent outcomes.This study aimed to assess the effect of preoperative tamsulosin on the intraoperative and postoperative outcomes of URS in the management of lower ureteric stones.Materials and methods:This was a double-blind randomized placebo-controlled clinical trial.A total of 80 patients were included,40 in each group.The closed envelope method of randomization was performed at the Assiut Urology and Nephrology Hospital(Urology Department),Faculty of Medicine,Assiut University,Egypt,from December 2019 to November 2021.Results:Both groups showed no significant differences in age,and themajority of patients in both groups weremale.Most patients had a moderate degree of obstruction,and the stones were radiopaque.Both groups showed insignificant differences in stone size(11.93±3.39 vs.12.40±4.24 mm,p=0.30).Operative time was significantly shorter in the study group than in the control group(61.50±23.99 vs.79.80±23.22 minutes,p=0.001).The control group had a significantly higher frequency of need for dilatation(80%vs.20%,p<0.001)and need to stent than the study group(60%vs.22.5%,p=0.001).Conclusions:Preoperative tamsulosin facilitates URS for lower ureteric stones.It decreases operative time,the need for dilation,and the need for postoperative indwelling ureteral stenting.It also increases the success rate but does not significantly affect the complication rate.展开更多
Background Improving the success rate of ureteroscopic lithotripsy for proximal ureteral stones is the hot issue in this field. Here we reported our experience on the treatment of proximal ureteral stones.Methods Fr...Background Improving the success rate of ureteroscopic lithotripsy for proximal ureteral stones is the hot issue in this field. Here we reported our experience on the treatment of proximal ureteral stones.Methods From 2005 to 2010, 187 consecutive patients with proximal ureteral stones who underwent ureteroscopic lithotripsy were enrolled. The initial 52 patients treated by semi-rigid ureteroscope alone were classified as group 1. The subsequent 135 patients treated by semi-rigid ureteroscope with the aid of stone basket and flexible ureteroscope were classified as group 2.Results In group 1, the overall stone-free rate was 67.3%. By a single procedure of ureteroscopic lithotripsy using a semi-rigid instrument, patients with ureteral stones below the 4th lumbar vertebra level achieved 91.7% stone-free rate, which was only 50% in patients with stones above the 4th lumbar vertebra level. Conversion to open surgery occurred in two patients since ureteral perforation was observed. In group 2, the stone-free rate achieved 93.2% with the aid of an N-Trap basket, which was significantly higher than that of patients without the aid of the basket （51.6%）. Flexible ureteroscope was subsequently used in patients with fragment migration, thus making the overall success rate in group 2 increases to 97.0%.Conclusions Ureteroscopic lithotripsy is a safe and efficacious treatment for proximal ureteral stones. A single procedure of ureteroscopic lithotripsy using semi-rigid ureteroscope could achieve a satisfactory stone-free rate in patients with proximal ureteral stones below the 4th lumbar vertebra level. However, patients with ureteral stones above the 4th lumbar vertebra level experienced higher stone-migration rate, which would decrease the success rate. Fortunately, the stone-free state could possibly be achieved with the aid of an N-trap basket and flexible ureteroscope.展开更多
Purpose::To investigate the clinical value of urine interleukin-18(IL-8),neutrophil gelatinase-associated lipocalin(NGAL)and kidney injury molecule-1(KIM-1)for the early diagnosis of acute kidney injury(AKI)in patient...Purpose::To investigate the clinical value of urine interleukin-18(IL-8),neutrophil gelatinase-associated lipocalin(NGAL)and kidney injury molecule-1(KIM-1)for the early diagnosis of acute kidney injury(AKI)in patients with ureteroscopic lithotripsy(URL)related urosepsis.Methods::A retrospective study was carried out in 157 patients with urosepsis after URL.The patients were divided into AKI group and non-AKI group according to the Kidigo guideline and urine IL-8,NGAL and KIM-1 levels were detected by enzyme-linked immunosorbent assay at 0,4,12,24 and 48 h after the surgery.Receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of these three biomarkers for postoperative AKI.Results::The level of urine IL-8,NGAL and KIM-1 in AKI group was significantly higher than that in non-AKI group at 4,12,24 and 48 h(p<0.01).The ROC analysis showed the combined detection of urine IL-8,NGAL and KIM-1 at 12 h had a larger area under curve(AUC)than a single marker(0.997,95%CI:0.991-0.998),and the sensitivity and specificity were 98.2%and 96.7%,respectively.Pearson correlation analysis showed that the levels of urine NGAL at 4,12,24 and 48 h in AKI patients were positively correlated with the levels of urine KIM-1 and IL-18(p<0.01).Conclusion::AKI could be quickly recognized by the elevated level of urine IL-8,NGAL and KIM-1 in patients with URL-related urosepsis.Combined detection of the three urine biomarkers at 12 h after surgery had a better diagnostic performance,which may be an important reference for the early diagnosis of AKI.展开更多
Objective The objective of this study is to assess the effectiveness and safety of ureteroscopic lithotripsy and flexible ureteroscopy(fURS)for treating patients on anticoagulant(AC)or antiplatelet(AP)medications.Pati...Objective The objective of this study is to assess the effectiveness and safety of ureteroscopic lithotripsy and flexible ureteroscopy(fURS)for treating patients on anticoagulant(AC)or antiplatelet(AP)medications.Patients and Methods The study included 213 patients with urinary stones who underwent ureteroscopic lithotripsy or fURS between January 2019 and October 2022 at the Shanghai Municipal Hospital Urology Specialist Alliance.Among these patients,15 received AC therapy,193 received AP therapy,and 5 received both AC and AP therapy.Patients were divided into 3 groups based on the real-world management of antithrombotic drugs:the continuation group(n=62),the discontinuation group(n=91),and the discontinuation and bridge heparin group(n=60).Intraoperative and postoperative outcomes were compared among the 3 groups.Results Age,sex,body mass index,stone location,stone size,stone side,and residual fragments were not different among the groups.None of the patients received blood transfusions or had thromboembolic events,emergencies for gross hematuria,significant bleeding-related complications,or unplanned secondary ureteroscopic surgery.The mean duration of hospital stay of the continuation group(3.97 days)was significantly lower than that of the discontinuation group(5.99 days)and the discontinuation and bridge heparin group(5.75 days)(p<0.001).Conclusions Ureteroscopic lithotripsy and fURS can be performed safely and effectively in patients on AC or AP drugs,resulting in reduced duration of hospital stay.展开更多
Objective: To observe the effect of acupoint massage in relieving pain after ureteroscopic holmium laser lithotripsy. Methods: Ninety-two patients undergone ureteroscopic holmium laser lithotripsy were enrolled and ra...Objective: To observe the effect of acupoint massage in relieving pain after ureteroscopic holmium laser lithotripsy. Methods: Ninety-two patients undergone ureteroscopic holmium laser lithotripsy were enrolled and randomized into a treatment group and a control group, 46 in each group. Patients in the control group were given regular nursing care, while patients in the treatment group were intervened by acupoint massage in addition to the regular nursing care. The pain was evaluated by visual analogue scale(VAS) at 6 h, 12 h, and 24 h after operation, and compared between the two groups. Results: There was no significant difference in comparing the VAS score at 6 h after operation between the two groups(P>0.05). The VAS scores in the treatment group at 12 h and 24 h after operation were significantly lower than those in the control group(both P<0.05). Fewer patients in the treatment group used analgesics compared with those in the control group.Conclusion: Acupoint massage can effectively relieve the pain after ureteroscopic holmium laser lithotripsy, reduce the use of analgesics, and promote the recovery.展开更多
RADICAL nephroureterectomy is the gold standardtreatment for patients with upper urinary tracturothelial cell carcinomas.1 However, ureteroscopehas enabled urologists to easily approach theupper urinary tract and rese...RADICAL nephroureterectomy is the gold standardtreatment for patients with upper urinary tracturothelial cell carcinomas.1 However, ureteroscopehas enabled urologists to easily approach theupper urinary tract and resect tumor.2 Patients for whomendoscopic tumor resection is recommended includedthose with a solitary kidney, renal insufficiency, bilateraltransitional cell carcinoma （TCC） of the upper urinary tract。展开更多
Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symp...Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symptoms.This study aimed to evaluate the J-Fil ureteral stent,a single pigtail suture stent compared with conventional DJ stent in relation to stent symptoms in an Asian population undergoing ureterorenal intervention.Methods:Based on internal audit committee recommendation approval,the records of 50 patients retrieved,available data of 41 patients who were prospectively enrolled into two groups(Group 1[J-Fil stent group],n=21 and Group 2[DJ stent group],n=20)between August 2020 to January 2021,were analysed.Parameters compared were nature of procedure,stone location and size,ease of deployment or removal,and complications.A modified universal stent symptom questionnaire was used to assess morbidity of stent symptoms within 48 h of insertion and at removal.Results:Both groups had similar median age,distribution in male to female ratio,and stone size.The overall median universal stent symptom questionnaire score at insertion was similar for bladder pain,flank or loin pain,and quality of life between Group 1 and 2;however,at removal Group 1 fared significantly better than Group 2,especially for flank or loin pain and pain at voiding.Both groups had similar ease in insertion with no hospital readmissions.Conclusion:Our audit favoured the single pigtail suture stent in Asian ureters in mitigating stent-related issues.It showed a good safety profile with easy deployment and removal.It promises a new standard in stenting.展开更多
Objective Ureteral lesions caused by impacted ureteral stones are likely to result in postoperative ureteral stricture.On this basis,the study aimed to investigate if dual-energy spectral computed tomography can predi...Objective Ureteral lesions caused by impacted ureteral stones are likely to result in postoperative ureteral stricture.On this basis,the study aimed to investigate if dual-energy spectral computed tomography can predict ureteral hardening caused by impacted stones and to explore the relationship between different types of ureteral lesions and the risk of ureteral stricture.Methods This prospective study collected data of 93 patients with impacted stones from hospital automation system during January 2018 to October 2019.They underwent an abdominal scan on a dual-energy spectral computed tomography.During surgery,the operator used ureteroscopy to identify ureteral lesions,which were classified into four categories:edema,polyps,pallor,and hardening.Seven months later,90 patients were reviewed for the degree of hydronephrosis.Results Endoscopic observations revealed 38(41%)cases of ureteral edema,20(22%)cases of polyps,13(14%)cases of pallor,and 22(24%)cases of hardening.There were significant differences in hydronephrosis,the period of impaction,the calcium concentration of the ureter,and the slope of the spectral Hounsfield unit curve between the four groups.After that,we evaluated the factors associated with ureteral hardening and found that the calcium concentration of the ureter and hydronephrosis remained independent predictors of ureteral hardening.Receiver operating characteristic curve analysis showed that 5.3 mg/cm^(3)calcium concentration of the ureter is an optimal cut-off value to predict ureteral hardening.The result of follow-up showed that 80 patients had complete remission of hydronephrosis,with a complete remission rate of 61.9%(13/21)in the hardening group and 97.1%(67/69)in the non-hardening group(p<0.001).Conclusion Calcium concentration of the ureter is an independent predictor of ureteral hardening.Patients with ureteral hardening have more severe hydronephrosis after ureteroscopic lithotripsy.When the calcium concentration of the ureter is less than 5.3 mg/cm^(3),ureteral lesions should be actively treated.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
objective: to analyze the therapeutic effects of soft ureteroscopic holmium laser lithotriptomy (RIRS) and microchannel percutaneous nephrolithotriptomy (mPCNL) in the treatment of upper ureteral calculi with diameter...objective: to analyze the therapeutic effects of soft ureteroscopic holmium laser lithotriptomy (RIRS) and microchannel percutaneous nephrolithotriptomy (mPCNL) in the treatment of upper ureteral calculi with diameter ≤2cm. Methods: a total of 53 patients with upper ureteral calculi ≤2cm admitted in our hospital from May 2020 to May 2021 were selected as the study subjects. Patients in the control group were treated with soft ureteroscopic holmium laser lithotripsy, while patients in the observation group were treated with microchannel percutaneous nephrolithotomy. Results: compared with the control group, the calculus clearance rate of patients in the observation group was relatively higher after treatment, and the incidence of pulmonary infection, bleeding, sepsis and other complications was relatively lower. Conclusion: for 2 cm or less Duan Jieshi patients treated in the process of the ureter, compared with soft ureter mirror holmium laser lithotripsy, using microchannel percutaneous nephroscope lithotripsy removed, not only can effectively improve the patient's one-time calculi clearance rate, at the same time also can effectively reduce the probability of patients with complications, relevant treatment in clinical use value is higher.展开更多
Objective: to investigate the value of self-made negative pressure aspirator combined with ureteroscopic lithotripsy (URL) in the treatment of upper urinary calculi. Methods: 178 patients with upper urinary calculi we...Objective: to investigate the value of self-made negative pressure aspirator combined with ureteroscopic lithotripsy (URL) in the treatment of upper urinary calculi. Methods: 178 patients with upper urinary calculi were divided into two groups according to different treatment methods, 89 cases in each group. Patients in the control group were treated with conventional URI, and patients in the observation group were treated with self-made negative pressure suction device combined with URI. The surgical indicators, complications and therapeutic effects of patients in the two groups were observed. Results: the renal pressure, operation time, postoperative hospital stay, intraoperative blood loss, WBC count, neutrophil percentage, PCT value and CRP value in the observation group were significantly lower than those in the control group (P < 0.01), and the differences were statistically significant (P < 0.05). The primary stone clearance rate in the observation group was higher than that in the control group (P < 0.05), and the intraoperative stone escape rate, postoperative fever incidence and postoperative septic shock incidence in the observation group were significantly lower than those in the control group (P < 0.05), with statistically significant differences. Conclusion: the self-made negative pressure suction device combined with URL can significantly reduce the intraoperative calculus escape rate and the incidence of septic shock, and can significantly improve the primary calculus clearance rate with good effect.展开更多
Objective: to study the efficacy of ureteroscopic holmium laser lithotripsy (FURSL) and minimally invasive percutaneous nephrolithotripsy (MPCNL) in the treatment of 2 to 3 cm kidney stones. Methods: 160 urology patie...Objective: to study the efficacy of ureteroscopic holmium laser lithotripsy (FURSL) and minimally invasive percutaneous nephrolithotripsy (MPCNL) in the treatment of 2 to 3 cm kidney stones. Methods: 160 urology patients from January 2017 to January 2020 were 80 patients with ureteral stones of 2 to 3 cm, 80 patients (n80) and VAS80) before and after surgery, including renal function, change in infection index, pain visual simulation score (VAS). Conclusions: the 2dBUN, PCT and MPCNL groups after the P U R S L group (P <0.05) were lower than the MPCNL group (P <0.05). The postoperative 2dBUN and PCT groups (P <0.05) were all lower than those in the MPCNL group (P <0.05). The postoperative 2dBUN, PCT, and PCT groups (P <0.05) were all lower than those in the MPCNL group (P <0.05). In the PCT group, the postoperative 2dBUN, PCT, and PCT group (P <0.05) were all lower than those in the MPCNL group (P <0.05). No postoperative 2dBUN, PCT and PCT groups (P <0.05) (P <0.05);After surgery of the FURSL group, the 2dBUN, PCT and PCT group (P <0.05) were all lower than those of the MPCNL group (P <0.05). None of the results were statistically significant. The ureteroscopic holmium laser lithotripsy group applied natural cavity technology without surgical incision, which causes small harm to the patient, the patient recovers quickly after the operation, will not cause serious kidney damage, and the patient need not bear severe pain after surgery, and the chance of complications is relatively low. Compared with minimally invasive percutaneous nephrolithotripsy, the time will be longer for 2 to 3 cm, and the first surgical stone clearance is lower than that of minimally invasive percutaneous nephrolithotripsy. The time of treatment should also be determined by the state of the patients condition.展开更多
Objective: To analyze the main treatment status and shortcomings of flexible ureteroscopic holmium laser lithotripsy, and to investigate the specific effect of adding stone capsule in patients with renal calculi. Meth...Objective: To analyze the main treatment status and shortcomings of flexible ureteroscopic holmium laser lithotripsy, and to investigate the specific effect of adding stone capsule in patients with renal calculi. Methods: After consideration set implementation of kidney stones in patients with tubal soft lens holmium laser lithotripsy, involved in the scheme of the 100 cases information early in 2021, after screening, COINS as grouping treatment appliance, foundation treatment, stone tong capsules are the scenario mainly discusses measures to plan after the collection of related data in early 2022, The relevant life parameters, treatment profile, pain and utility survey were used as the basis for the conclusion. Results: The capsule group could live a normal life under the treatment effect and mechanism, and the optimization of the overall prognosis was more obvious in the objective evaluation. The prognosis life was developed according to the rehabilitation direction in the plan, and the utility value was fully verified (P < 0.05). In the capsule group, most of the stones could be discharged within the planned period of time, the time from operation to the discharge of gravel was shorter, and there was no accumulation of gravel after operation, and the utility value was fully verified (P < 0.05). With the general level of pain assessment for patients with different stages, the analysis of the level of pain to be in capsule group formed by stones in continuous medication pain symptoms were effectively controlled, gradually retreat from severe to mild, and that can be observed in patients with execution of nursing, nursing attitude are significantly increased, and the utility value fully test (P < 0.05);The results of utility analysis, analgesia analysis and applicability analysis in the capsule group fully showed that this measure was beneficial to the discharge and prognosis of stones, and its utility value was fully verified (P < 0.05). Conclusion: Jiyitong capsule is both targeted and scientific, and has significant effect on the excretion of renal stones in patients, which can effectively shorten the treatment cycle of patients and improve the overall quality of life展开更多
Aim： To investigate the causes and costs of flexible ureteroscope damage, and to develop recommendations to limit damage. Methods： The authors analysed repair figures and possible causes of damage to 35 instruments ...Aim： To investigate the causes and costs of flexible ureteroscope damage, and to develop recommendations to limit damage. Methods： The authors analysed repair figures and possible causes of damage to 35 instruments sent for repair to a leading UK supplier over a 1-year period, and calculated cost figures for maintenance of the instruments as opposed to repair and replacement costs. Results： All damages were handling-induced and therefore did not fall under the manufacturer＇s warranty： 28 % were damaged by misfiring of the laser inside the instrument; 72 %, mainly crushing and stripping of the ureteroscope shaft tube, were likely to have occurred during out-of-surgery handling, washing and disinfection. Seventeen （4 %） instruments were not repaired and consequently taken out of service due to the extensive costs involved. Eighteen （51%） ureteroscopes were repaired at an average cost of 10 833 USD. Conclusion： Damages to flexible ureteroscopes bear considerable costs. Most damages occur during handling between surgical procedures. Thorough adherence to handling procedures, and courses for theater staff and surgeons on handling flexible instruments may help to reduce these damages and prove a cost-saving investment. The authors provide a list of recommended procedural measures that may help to prevent such damages.展开更多
文摘Objective:To analyze the effect of Shiwei Powder combined with stone composition analysis on stone removal efficiency and complication rates after ureteroscopic holmium laser lithotripsy(FURL).Methods:Ninety six patients with FURL admitted to the hospital from March 2023 to March 2025 were selected and randomly divided into two groups.The observation group was treated with FURL combined with Shiwei Powder,while the control group was treated with FURL monotherapy.Based on the stone composition of the two groups,the stone removal efficiency,complication rates,recurrence rates,TCM syndrome scores,and inflammatory factor levels were compared.Results:The stone removal efficiency of the observation group was higher than that of the control group.The stone composition was mainly calcium oxalate monohydrate and composite stones containing calcium oxalate monohydrate.The incidence of postoperative complications was lower in the observation group than in the control group(P<0.05).After 3–6 months of follow-up,the recurrence rate in the observation group was lower than that in the control group(P<0.05).After treatment,the TCM syndrome scores and inflammatory factor levels in the observation group were lower than those in the control group(P<0.05).Conclusion:Based on the results of urinary stone composition analysis,patients treated with Shiwei Powder after FURL have higher stone removal efficiency.The most significant effect is observed in urinary stones composed of calcium oxalate monohydrate and composite stones containing calcium oxalate monohydrate.This treatment can improve stone removal,prevent complications,reduce recurrences,effectively improve disease symptoms,and reduce inflammation.
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.
基金Supported by The National Natural Science Foundation of China,No.31660293.
文摘BACKGROUND Drainage tube removal is difficult when the greater omentum becomes incarcerated in the drainage tube through the side holes.Currently,known removal methods are either ineffective or will cause additional damage to the patient in a secondary operation.Ureteroscopy and the holmium laser have been used in various surgical techniques in urology,and in theory,they are expected to be a good strategy for solving the problem of tissue incarceration.CASE SUMMARY Four patients diagnosed with difficult removal of an abdominal drainage tube following abdominal surgery are reported.All patients underwent surgery to remove the incarcerated greater omentum in the drainage tube using a holmium laser and a ureteroscope,and a new 16-F drain was then placed in the abdominal or pelvic cavity.The efficacy of this technique was evaluated by intraoperative conditions,success rate,and operating time;safety was evaluated by perioperative conditions and the probability of postoperative complications.All four operations went smoothly,and the drains were successfully removed in all patients.The average operating time was 24.5 min.Intraoperatively,the average irrigation volume was 892.0 mL,the average drainage volume was 638.5 mL,and no bleeding or damage to surrounding tissues was observed.Postoperatively,the average drainage volume was 32.8 mL and the new drains were removed within 36 h.All patients were able to get out of bed and move around within 12 h.Their visual analogue pain scores were all below 3.The average follow-up duration was 12.5 mo and no complications such as fever or bleeding were noted.CONCLUSION Ureteroscopic holmium laser surgery is an effective,safe and minimally invasive technique for removing drains where the greater omentum is incarcerated in the abdominal drain.
文摘Objective: to analyze the operation and nursing methods of ureteroscopic pneumatic lithotripsy for urethral calculi. Methods: a total of 120 patients who were treated for urethral calculi in our hospital in 2021 were randomly divided into observation group and control group, with 60 patients in each group. Both groups of patients will be treated with pneumatic lithotripsy under ureteroscope after entering our hospital. Patients in the observation group will receive comprehensive care, while those in the control group will receive general care. After the treatment, the operation, nursing satisfaction, postoperative complications and hospitalization of the two groups were compared. Results: the observation group showed more advantages in operation and nursing satisfaction. Conclusion: patients suffering from urethral calculi and receiving pneumatic lithotripsy under ureteroscope should use more advanced comprehensive care and the final treatment effect will be better, which is worth popularizing.
文摘Objective: to analyze and study the nursing methods and nursing effects of patients with upper urinary tract stones after treatment with ureteroscopic holmium laser lithotripsy. Methods: the study began in January 2020 and ended in November 2021. Forty-eight patients who came to the hospital for treatment during the study period were selected as the research objects. All of them were hospitalized for upper urinary tract stones. They were divided into two different groups by random drawing of lots. They were named as the contrast group and the observation group, with 24 patients in each group. Holmium laser lithotripsy with flexible ureteroscope was used as the treatment between the two groups. The former received surgical treatment while carrying out routine care, while the latter carried out comprehensive care. The nursing effect between the groups was compared and analyzed. Results: compared with the two groups, the operation index of the observation group was better (p < 0.05). The clinical indexes of the observation group improved more (P < 0.05). The observation group had a relatively lower incidence of complications and higher nursing satisfaction (P < 0.05). In terms of quality of life, the observation group improved better (P < 0.05). Conclusion: in the process of implementing ureteroscopic holmium laser lithotripsy for patients with upper urinary tract calculi, combined with comprehensive nursing intervention can produce a relatively ideal intervention effect, which is suitable for universal use.
文摘Background:The use of tamsulosin before semirigid ureteroscopy(URS)for proximal ureteral stones increases operative success.Several authors have usedα-blockers for dilation of the ureter,andmost studies have observed a higher stone-free rate and fewer complications than those with a placebo or no use of drugs.Ureteroscopy is the standard treatment for ureteral stones and has excellent outcomes.This study aimed to assess the effect of preoperative tamsulosin on the intraoperative and postoperative outcomes of URS in the management of lower ureteric stones.Materials and methods:This was a double-blind randomized placebo-controlled clinical trial.A total of 80 patients were included,40 in each group.The closed envelope method of randomization was performed at the Assiut Urology and Nephrology Hospital(Urology Department),Faculty of Medicine,Assiut University,Egypt,from December 2019 to November 2021.Results:Both groups showed no significant differences in age,and themajority of patients in both groups weremale.Most patients had a moderate degree of obstruction,and the stones were radiopaque.Both groups showed insignificant differences in stone size(11.93±3.39 vs.12.40±4.24 mm,p=0.30).Operative time was significantly shorter in the study group than in the control group(61.50±23.99 vs.79.80±23.22 minutes,p=0.001).The control group had a significantly higher frequency of need for dilatation(80%vs.20%,p<0.001)and need to stent than the study group(60%vs.22.5%,p=0.001).Conclusions:Preoperative tamsulosin facilitates URS for lower ureteric stones.It decreases operative time,the need for dilation,and the need for postoperative indwelling ureteral stenting.It also increases the success rate but does not significantly affect the complication rate.
文摘Background Improving the success rate of ureteroscopic lithotripsy for proximal ureteral stones is the hot issue in this field. Here we reported our experience on the treatment of proximal ureteral stones.Methods From 2005 to 2010, 187 consecutive patients with proximal ureteral stones who underwent ureteroscopic lithotripsy were enrolled. The initial 52 patients treated by semi-rigid ureteroscope alone were classified as group 1. The subsequent 135 patients treated by semi-rigid ureteroscope with the aid of stone basket and flexible ureteroscope were classified as group 2.Results In group 1, the overall stone-free rate was 67.3%. By a single procedure of ureteroscopic lithotripsy using a semi-rigid instrument, patients with ureteral stones below the 4th lumbar vertebra level achieved 91.7% stone-free rate, which was only 50% in patients with stones above the 4th lumbar vertebra level. Conversion to open surgery occurred in two patients since ureteral perforation was observed. In group 2, the stone-free rate achieved 93.2% with the aid of an N-Trap basket, which was significantly higher than that of patients without the aid of the basket （51.6%）. Flexible ureteroscope was subsequently used in patients with fragment migration, thus making the overall success rate in group 2 increases to 97.0%.Conclusions Ureteroscopic lithotripsy is a safe and efficacious treatment for proximal ureteral stones. A single procedure of ureteroscopic lithotripsy using semi-rigid ureteroscope could achieve a satisfactory stone-free rate in patients with proximal ureteral stones below the 4th lumbar vertebra level. However, patients with ureteral stones above the 4th lumbar vertebra level experienced higher stone-migration rate, which would decrease the success rate. Fortunately, the stone-free state could possibly be achieved with the aid of an N-trap basket and flexible ureteroscope.
基金This article was sponsored by Medical Research Foundation of Chongqing,China(2019MSXM034).
文摘Purpose::To investigate the clinical value of urine interleukin-18(IL-8),neutrophil gelatinase-associated lipocalin(NGAL)and kidney injury molecule-1(KIM-1)for the early diagnosis of acute kidney injury(AKI)in patients with ureteroscopic lithotripsy(URL)related urosepsis.Methods::A retrospective study was carried out in 157 patients with urosepsis after URL.The patients were divided into AKI group and non-AKI group according to the Kidigo guideline and urine IL-8,NGAL and KIM-1 levels were detected by enzyme-linked immunosorbent assay at 0,4,12,24 and 48 h after the surgery.Receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of these three biomarkers for postoperative AKI.Results::The level of urine IL-8,NGAL and KIM-1 in AKI group was significantly higher than that in non-AKI group at 4,12,24 and 48 h(p<0.01).The ROC analysis showed the combined detection of urine IL-8,NGAL and KIM-1 at 12 h had a larger area under curve(AUC)than a single marker(0.997,95%CI:0.991-0.998),and the sensitivity and specificity were 98.2%and 96.7%,respectively.Pearson correlation analysis showed that the levels of urine NGAL at 4,12,24 and 48 h in AKI patients were positively correlated with the levels of urine KIM-1 and IL-18(p<0.01).Conclusion::AKI could be quickly recognized by the elevated level of urine IL-8,NGAL and KIM-1 in patients with URL-related urosepsis.Combined detection of the three urine biomarkers at 12 h after surgery had a better diagnostic performance,which may be an important reference for the early diagnosis of AKI.
基金Shanghai Municipal Hospital Urology Specialist Alliance(grant no.SHDC22021314-A,SHDC22021314-B)Scientific and Technological Innovative Action Plan from Science and Technology Commission of Shanghai Municipality(grant nos.20Y11904600 and 23141902100)+1 种基金Shanghai Pujiang Program(grant no.2020PJD046)Science and Technology Foundation of Songjiang District(grant no.18sjkjgg13).
文摘Objective The objective of this study is to assess the effectiveness and safety of ureteroscopic lithotripsy and flexible ureteroscopy(fURS)for treating patients on anticoagulant(AC)or antiplatelet(AP)medications.Patients and Methods The study included 213 patients with urinary stones who underwent ureteroscopic lithotripsy or fURS between January 2019 and October 2022 at the Shanghai Municipal Hospital Urology Specialist Alliance.Among these patients,15 received AC therapy,193 received AP therapy,and 5 received both AC and AP therapy.Patients were divided into 3 groups based on the real-world management of antithrombotic drugs:the continuation group(n=62),the discontinuation group(n=91),and the discontinuation and bridge heparin group(n=60).Intraoperative and postoperative outcomes were compared among the 3 groups.Results Age,sex,body mass index,stone location,stone size,stone side,and residual fragments were not different among the groups.None of the patients received blood transfusions or had thromboembolic events,emergencies for gross hematuria,significant bleeding-related complications,or unplanned secondary ureteroscopic surgery.The mean duration of hospital stay of the continuation group(3.97 days)was significantly lower than that of the discontinuation group(5.99 days)and the discontinuation and bridge heparin group(5.75 days)(p<0.001).Conclusions Ureteroscopic lithotripsy and fURS can be performed safely and effectively in patients on AC or AP drugs,resulting in reduced duration of hospital stay.
基金supported by Tongxiang Hospital of Chinese Medicine
文摘Objective: To observe the effect of acupoint massage in relieving pain after ureteroscopic holmium laser lithotripsy. Methods: Ninety-two patients undergone ureteroscopic holmium laser lithotripsy were enrolled and randomized into a treatment group and a control group, 46 in each group. Patients in the control group were given regular nursing care, while patients in the treatment group were intervened by acupoint massage in addition to the regular nursing care. The pain was evaluated by visual analogue scale(VAS) at 6 h, 12 h, and 24 h after operation, and compared between the two groups. Results: There was no significant difference in comparing the VAS score at 6 h after operation between the two groups(P>0.05). The VAS scores in the treatment group at 12 h and 24 h after operation were significantly lower than those in the control group(both P<0.05). Fewer patients in the treatment group used analgesics compared with those in the control group.Conclusion: Acupoint massage can effectively relieve the pain after ureteroscopic holmium laser lithotripsy, reduce the use of analgesics, and promote the recovery.
文摘RADICAL nephroureterectomy is the gold standardtreatment for patients with upper urinary tracturothelial cell carcinomas.1 However, ureteroscopehas enabled urologists to easily approach theupper urinary tract and resect tumor.2 Patients for whomendoscopic tumor resection is recommended includedthose with a solitary kidney, renal insufficiency, bilateraltransitional cell carcinoma （TCC） of the upper urinary tract。
文摘Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symptoms.This study aimed to evaluate the J-Fil ureteral stent,a single pigtail suture stent compared with conventional DJ stent in relation to stent symptoms in an Asian population undergoing ureterorenal intervention.Methods:Based on internal audit committee recommendation approval,the records of 50 patients retrieved,available data of 41 patients who were prospectively enrolled into two groups(Group 1[J-Fil stent group],n=21 and Group 2[DJ stent group],n=20)between August 2020 to January 2021,were analysed.Parameters compared were nature of procedure,stone location and size,ease of deployment or removal,and complications.A modified universal stent symptom questionnaire was used to assess morbidity of stent symptoms within 48 h of insertion and at removal.Results:Both groups had similar median age,distribution in male to female ratio,and stone size.The overall median universal stent symptom questionnaire score at insertion was similar for bladder pain,flank or loin pain,and quality of life between Group 1 and 2;however,at removal Group 1 fared significantly better than Group 2,especially for flank or loin pain and pain at voiding.Both groups had similar ease in insertion with no hospital readmissions.Conclusion:Our audit favoured the single pigtail suture stent in Asian ureters in mitigating stent-related issues.It showed a good safety profile with easy deployment and removal.It promises a new standard in stenting.
文摘Objective Ureteral lesions caused by impacted ureteral stones are likely to result in postoperative ureteral stricture.On this basis,the study aimed to investigate if dual-energy spectral computed tomography can predict ureteral hardening caused by impacted stones and to explore the relationship between different types of ureteral lesions and the risk of ureteral stricture.Methods This prospective study collected data of 93 patients with impacted stones from hospital automation system during January 2018 to October 2019.They underwent an abdominal scan on a dual-energy spectral computed tomography.During surgery,the operator used ureteroscopy to identify ureteral lesions,which were classified into four categories:edema,polyps,pallor,and hardening.Seven months later,90 patients were reviewed for the degree of hydronephrosis.Results Endoscopic observations revealed 38(41%)cases of ureteral edema,20(22%)cases of polyps,13(14%)cases of pallor,and 22(24%)cases of hardening.There were significant differences in hydronephrosis,the period of impaction,the calcium concentration of the ureter,and the slope of the spectral Hounsfield unit curve between the four groups.After that,we evaluated the factors associated with ureteral hardening and found that the calcium concentration of the ureter and hydronephrosis remained independent predictors of ureteral hardening.Receiver operating characteristic curve analysis showed that 5.3 mg/cm^(3)calcium concentration of the ureter is an optimal cut-off value to predict ureteral hardening.The result of follow-up showed that 80 patients had complete remission of hydronephrosis,with a complete remission rate of 61.9%(13/21)in the hardening group and 97.1%(67/69)in the non-hardening group(p<0.001).Conclusion Calcium concentration of the ureter is an independent predictor of ureteral hardening.Patients with ureteral hardening have more severe hydronephrosis after ureteroscopic lithotripsy.When the calcium concentration of the ureter is less than 5.3 mg/cm^(3),ureteral lesions should be actively treated.
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objective: to analyze the therapeutic effects of soft ureteroscopic holmium laser lithotriptomy (RIRS) and microchannel percutaneous nephrolithotriptomy (mPCNL) in the treatment of upper ureteral calculi with diameter ≤2cm. Methods: a total of 53 patients with upper ureteral calculi ≤2cm admitted in our hospital from May 2020 to May 2021 were selected as the study subjects. Patients in the control group were treated with soft ureteroscopic holmium laser lithotripsy, while patients in the observation group were treated with microchannel percutaneous nephrolithotomy. Results: compared with the control group, the calculus clearance rate of patients in the observation group was relatively higher after treatment, and the incidence of pulmonary infection, bleeding, sepsis and other complications was relatively lower. Conclusion: for 2 cm or less Duan Jieshi patients treated in the process of the ureter, compared with soft ureter mirror holmium laser lithotripsy, using microchannel percutaneous nephroscope lithotripsy removed, not only can effectively improve the patient's one-time calculi clearance rate, at the same time also can effectively reduce the probability of patients with complications, relevant treatment in clinical use value is higher.
文摘Objective: to investigate the value of self-made negative pressure aspirator combined with ureteroscopic lithotripsy (URL) in the treatment of upper urinary calculi. Methods: 178 patients with upper urinary calculi were divided into two groups according to different treatment methods, 89 cases in each group. Patients in the control group were treated with conventional URI, and patients in the observation group were treated with self-made negative pressure suction device combined with URI. The surgical indicators, complications and therapeutic effects of patients in the two groups were observed. Results: the renal pressure, operation time, postoperative hospital stay, intraoperative blood loss, WBC count, neutrophil percentage, PCT value and CRP value in the observation group were significantly lower than those in the control group (P < 0.01), and the differences were statistically significant (P < 0.05). The primary stone clearance rate in the observation group was higher than that in the control group (P < 0.05), and the intraoperative stone escape rate, postoperative fever incidence and postoperative septic shock incidence in the observation group were significantly lower than those in the control group (P < 0.05), with statistically significant differences. Conclusion: the self-made negative pressure suction device combined with URL can significantly reduce the intraoperative calculus escape rate and the incidence of septic shock, and can significantly improve the primary calculus clearance rate with good effect.
文摘Objective: to study the efficacy of ureteroscopic holmium laser lithotripsy (FURSL) and minimally invasive percutaneous nephrolithotripsy (MPCNL) in the treatment of 2 to 3 cm kidney stones. Methods: 160 urology patients from January 2017 to January 2020 were 80 patients with ureteral stones of 2 to 3 cm, 80 patients (n80) and VAS80) before and after surgery, including renal function, change in infection index, pain visual simulation score (VAS). Conclusions: the 2dBUN, PCT and MPCNL groups after the P U R S L group (P <0.05) were lower than the MPCNL group (P <0.05). The postoperative 2dBUN and PCT groups (P <0.05) were all lower than those in the MPCNL group (P <0.05). The postoperative 2dBUN, PCT, and PCT groups (P <0.05) were all lower than those in the MPCNL group (P <0.05). In the PCT group, the postoperative 2dBUN, PCT, and PCT group (P <0.05) were all lower than those in the MPCNL group (P <0.05). No postoperative 2dBUN, PCT and PCT groups (P <0.05) (P <0.05);After surgery of the FURSL group, the 2dBUN, PCT and PCT group (P <0.05) were all lower than those of the MPCNL group (P <0.05). None of the results were statistically significant. The ureteroscopic holmium laser lithotripsy group applied natural cavity technology without surgical incision, which causes small harm to the patient, the patient recovers quickly after the operation, will not cause serious kidney damage, and the patient need not bear severe pain after surgery, and the chance of complications is relatively low. Compared with minimally invasive percutaneous nephrolithotripsy, the time will be longer for 2 to 3 cm, and the first surgical stone clearance is lower than that of minimally invasive percutaneous nephrolithotripsy. The time of treatment should also be determined by the state of the patients condition.
文摘Objective: To analyze the main treatment status and shortcomings of flexible ureteroscopic holmium laser lithotripsy, and to investigate the specific effect of adding stone capsule in patients with renal calculi. Methods: After consideration set implementation of kidney stones in patients with tubal soft lens holmium laser lithotripsy, involved in the scheme of the 100 cases information early in 2021, after screening, COINS as grouping treatment appliance, foundation treatment, stone tong capsules are the scenario mainly discusses measures to plan after the collection of related data in early 2022, The relevant life parameters, treatment profile, pain and utility survey were used as the basis for the conclusion. Results: The capsule group could live a normal life under the treatment effect and mechanism, and the optimization of the overall prognosis was more obvious in the objective evaluation. The prognosis life was developed according to the rehabilitation direction in the plan, and the utility value was fully verified (P < 0.05). In the capsule group, most of the stones could be discharged within the planned period of time, the time from operation to the discharge of gravel was shorter, and there was no accumulation of gravel after operation, and the utility value was fully verified (P < 0.05). With the general level of pain assessment for patients with different stages, the analysis of the level of pain to be in capsule group formed by stones in continuous medication pain symptoms were effectively controlled, gradually retreat from severe to mild, and that can be observed in patients with execution of nursing, nursing attitude are significantly increased, and the utility value fully test (P < 0.05);The results of utility analysis, analgesia analysis and applicability analysis in the capsule group fully showed that this measure was beneficial to the discharge and prognosis of stones, and its utility value was fully verified (P < 0.05). Conclusion: Jiyitong capsule is both targeted and scientific, and has significant effect on the excretion of renal stones in patients, which can effectively shorten the treatment cycle of patients and improve the overall quality of life
文摘Aim： To investigate the causes and costs of flexible ureteroscope damage, and to develop recommendations to limit damage. Methods： The authors analysed repair figures and possible causes of damage to 35 instruments sent for repair to a leading UK supplier over a 1-year period, and calculated cost figures for maintenance of the instruments as opposed to repair and replacement costs. Results： All damages were handling-induced and therefore did not fall under the manufacturer＇s warranty： 28 % were damaged by misfiring of the laser inside the instrument; 72 %, mainly crushing and stripping of the ureteroscope shaft tube, were likely to have occurred during out-of-surgery handling, washing and disinfection. Seventeen （4 %） instruments were not repaired and consequently taken out of service due to the extensive costs involved. Eighteen （51%） ureteroscopes were repaired at an average cost of 10 833 USD. Conclusion： Damages to flexible ureteroscopes bear considerable costs. Most damages occur during handling between surgical procedures. Thorough adherence to handling procedures, and courses for theater staff and surgeons on handling flexible instruments may help to reduce these damages and prove a cost-saving investment. The authors provide a list of recommended procedural measures that may help to prevent such damages.
