Selection of operation plan for patients with complex upper ureteral calculi and the effect of stone removal and lithotripsy
Li Wenwei
Zhou Wei
Ding Zhibing
Wu Wenbing
Zhu Hanliang
Abstract：Objective:To investigate the effects of different operation plans in the treatment of patients with complex upper ureteral calculi (CUU)and the effect of stone removal and lithotripsy.Methods:The clinical data of 348 patients with CUU were analyzed retrospectively.Thirty-three patients were respectively selected from pa-tients undergoing ureteoscopic pneumatic lithotripsy (URSL),percutaneous nephrolithotomy (PCNL),extracor-poreal shock wave lithotripsy (ESWL)and retroperitoneal laparoscopic ureterolithotomy (RLU).They were in-cluded in group A,group B,group C and group D,respectively (a total of 132 effective cases enrolled in the stud-y).The time of lithotripsy,operation process,intraoperative blood loss,total length of hospital stay,treatment costs and other perioperative indicators were compared among the four groups.The success rate of once operation, stone-free rate (SFR),rate of twice or more times operation and the incidence rate of postoperative related compli-cations were recorded.The calculus components were analyzed.Results:The perioperative related indicators,suc-cess rates of once operation and SFR in group A and group C were significantly lower than those in group B and group D (P<0.05)while the success rates of twice or more times operation were significantly higher than those in group B and group D (P<0.05).During the postoperative 12 months of follow-up,the incidence rate of ad-verse reactions in group B (48.5%)was significantly higher than that in other three groups (P<0.05).The pro-portion of calcium oxalate calculus was the highest in all group (P>0.05).Conclusions:URSL has short duration and less trauma,but the success rate of once operation and SFR are low;PCNL is ideal for the treatment of SFR, but the risk of postoperative complications is high;The treatment costs of ESWL is low,with less trauma and pa-tients do not need to be hospitalized after operation,but the success rate of once operation and SFR are low;The success rate of once operation and SFR of RLU are high,and the risk of postoperative complications is low howev-er,there is a greater probability of accidental inj ury.Therefore,the best operation should be chosen according to the actual situation.
Keywords：upper ureteracalculieffect of lithotripsyoperation method
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 213-217 )