Clinical analysis of flexible ureterorenoscopy with holmium laser lithotripsy in management of lower pole stones

Peng Junming; Zhu Qingguo; Li Tao; Gao Xiangxun; Zhang Yanrong; Ye Liefu

doi:10.19558/j.cnki.10-1020/r.2017.05.008

Abstract：Objective:To evaluate the efficacy of flexible ureterorenoscopy with holmium laser lithotripsy (FURS) in management of lower pole stones.Methods:Ninety-three cases of lower pole stone received FURS between January 2015 and March 2017.The residual stones and the position of double-J stents were evaluated with kidney,ureter and bladder X-ray (KUB) on the first postoperative day.Patients can be discharged from hospital on the third postoperative day.The double-J stents were removed on the second postoperative week.The stone-free rate of all patients was evaluated using KUB on the first postoperative month.Results:All 93 patients were treated successfully.The median stone size was (14.6±4.5) mm.The mean operation time was (68.2±19.1) min.The mean hospital stay was (3.9±1.0) d.The final stone-free rate of all patients was 79.5％ (74/93) on fist month postoperatively.In the groups of stone diameter ＜20 mm and ≥20 mm,the stone-free rate was 87.3％ (62/71)and 54.5％ (12/22) respectively with the difference being statistically significant between two groups (x2=11.101,P =0.001).The stone-free rate in patients with the infundibulopelvic angle (IPA) ＞30° and IPA ≤30°was 88.7％ (55/62) and 61.2％ (19/31) respectively with the difference being statistically significant between two groups (x2 =9.556,P=0.002).Postoperative fever greater than 38.5℃ was noted in 7 cases.No other severe complication occurred.Conclusions:The FURS was a safe and effective way to treat lower pole stones,with a low complication rate.It can be a main method for the treatment of lower pole stones in some selective patients.But the stone size and IPA can significantly impact the stone-free rate.