Re: Huang et al.: The Application of Suctioning Flexible Ureteroscopy With Intelligent Pressure Control in Treating Upper Urinary Tract Calculi on Patients With a Solitary Kidney (Urology 2018;111:44-47)

We evaluated the clinical value of flexible ureteroscopic lithotripsy for the treatment of upper urinary tract calculi in infants. Fifty-five infants with upper urinary tract calculi were included in this study: 41 males and 14 females. Retrograde intrarenal surgery was performed by an 8 Fr/30 cm flexible ureterorenoscope (POLY®) combined with a holmium laser. CT scanning or radiography of the kidneys, ureters, and bladder region was performed one month after the operation to confirm the clearance of calculi. All the 55 infants with calculi in 74 sides underwent 66 flexible ureteroscopic lithotripsy procedures. The median operation time was 30 min. The median amount of flushing fluid was 500 mL. The stone-free rate after a single session treatment was 94.6%, within which 10 infants underwent simultaneous bilateral flexible ureteroscopy lithotripsy. Catheters were retained in 45 infants for 24–48 h after the operation. Continuous high fever due to reflux was present in two cases. Flushing fluid extravasation was found in one infant. Some patients with minor complications, such as mild hematuria, irritation symptoms, and low fever, recovered without treatment. The duration of hospitalization time after the operation was approximately 1–5 days. Flexible ureteroscopic lithotripsy is a safe, highly efficient, minimally invasive, and reproducible operation for removal of upper urinary tract calculi in infants. This technique is a convenient method for postoperative management of patients that enhances their rapid recovery. It is a promising option for therapy of infants ineffectively treated by extracorporeal shockwave lithotripsy.

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Outcomes of flexible ureteroscopy and laser lithotripsy (FURSL) for treatment of the upper urinary tract calculi: a single center experience

10.22541/au.161962291.10436373/v1 ◽

2021 ◽

Author(s):

Wei Tao ◽

Ming Xu ◽

Yachen Zang ◽

Jin Zhu ◽

Boxin Xue ◽

...

Keyword(s):

Urinary Tract ◽

Upper Urinary Tract ◽

Laser Lithotripsy ◽

Flexible Ureteroscopy ◽

Successful Operation ◽

Stone Removal ◽

Single Center Experience ◽

Extracorporeal Shock Wave ◽

Urinary Tract Calculi ◽

Upper Urinary Tract Calculi

purpose: To evaluate the efficacy and safety of flexible ureteroscopy and laser lithotripsy(FURSL) for treatment of the upper urinary tract calculi. Methods: We retrospectively analyzed 784 patients who underwent FURSL between January 2015 to October 2020 in our unit. The operative parameters, postoperative functional outcomes and complications were recorded respectively. Rusults: All patients underwent successful operation. The mean operative time was 46.9±15.8min. The average postoperative hospital stay was 1.2±1.1 days. The postoperative serum creatinine and hemoglobin were 76.2±10.2umol/L and 133.6±5.1g/L, which compared to preoperative, there were no sigificant statistical difference. Among 784 patients, 746 patients were followed up and 38 patients were lost. 700(93.8%) cases met the stone removal critetia and 46 cases(6.2%) did not meet the stone removal criteria for other treatments, such as extracorporeal shock wave lithotripsy, ureteroscopy and observed regularly. The stone free rate(SFR) is 92.5% after 1-3 months and SFR of middle and upper calyceal calculi was higher than that of lower calyceal calculi significantly. The most common complications were fever(58/784,7.4%),gross hematuria(540/784,68.88%) and lpsilateral low back pain(47/784,5.99). The incidence rate of serious complication was 1.28%(10/784), including 5 cases of septic shock and 5 cases of subcapsular hematoma, which were cured after active treatment. Conclusion: FURSL is a reliable treatment for small and medium calculi patients of upper urinary tract. The curative effect of stone removal is clear,the complications are few and the safety is high. However there are certain limitation to the efficacy in the treatment of large stone and lower calyceal calculi.

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