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学科主题: 临床医学
题名:
Retrograde, Antegrade, and Laparoscopic Approaches to the Management of Large Upper Ureteral Stones After Shockwave Lithotripsy Failure: A Four-Year Retrospective Study
作者: Zhu, Hongjian1; Ye, Xiongjun2; Xiao, Xuren1; Chen, Xianglong1; Zhang, Qingjiang1; Wang, Hua1
刊名: JOURNAL OF ENDOUROLOGY
发表日期: 2014
DOI: 10.1089/end.2013.0391
卷: 28, 期:1, 页:100-103
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: PERCUTANEOUS NEPHROLITHOTOMY ; SEMIRIGID URETEROSCOPY ; URETEROLITHOTOMY ; COMPLICATIONS ; DISEASE
英文摘要:

Purpose: We compare the success rate and complications of retrograde ureteroscopy, laparoscopic ureterolithotomy, and percutaneous nephrolithotomy for the management of large upper ureteral stones. Patients and Methods: We retrospectively analyzed data from 73 patients with large (1cm) upper ureteral stones at two institutions from January 2010 to May 2013. Twenty-two patients underwent retrograde ureteroscopy (group ULS), 30 patients underwent percutaneous nephrolithotripsy (group PCNL), and 21 patients underwent laparoscopic ureterolithotomy (group LS) for removal of upper ureteral stones. CT, intravenous urography, and ultrasound were performed 1 week and 1 month after surgical removal. Results: There were no significant differences in age, sex, or stone size among the three groups. Mean estimated blood loss and mean hospital stay showed a statistically significant difference among the three groups. Success rates in the PCNL, LS, and ULS groups were 100%, 90.5%, and 77.3%, respectively. The procedures of two patients in group LS were converted to open surgery because of the inability to find the ureteral stone in one patient and an adhesion too difficult to dissect in the other. The procedures of two patients in the ULS group were converted to LS, and those of three patients were converted to PCNL because of severe edema impaction at the site of the stone, a sharply angulated ureter obstruction, upward migration of the stone (seven patients), and intraoperative complications (two patients). Conclusions: Percutaneous antegrade nephrolithotomy is a safe and effective minimally invasive treatment for patients with large upper ureteral stones that has several advantages over retrograde ureteroscopy and laparoscopic ureterolithotomy. Thus, percutaneous antegrade nephrolithotomy is recommended as a safe and good treatment option for large upper ureteral stones. A combined procedure (e.g., ureteral push-back and percutaneous removal) can be considered in some patients.

语种: 英语
WOS记录号: WOS:000329361400018
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/68010
Appears in Collections:北京大学第二临床医学院_泌尿外科_期刊论文

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作者单位: 1.Gen Hosp Armed Police Forces China, Dept Urol, Beijing, Peoples R China
2.Peking Univ Peoples Hosp, Dept Urol, Beijing 100034, Peoples R China

Recommended Citation:
Zhu, Hongjian,Ye, Xiongjun,Xiao, Xuren,et al. Retrograde, Antegrade, and Laparoscopic Approaches to the Management of Large Upper Ureteral Stones After Shockwave Lithotripsy Failure: A Four-Year Retrospective Study[J]. JOURNAL OF ENDOUROLOGY,2014,28(1):100-103.
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