The clinical outcomes of flexible ureteroscopy and laser lithotripsy (FURSL) for treatment of the upper urinary tract calculi

2021 ◽  
pp. 1-11
Author(s):  
Wei Tao ◽  
Xu Ming ◽  
Yachen Zang ◽  
Jin Zhu ◽  
Yuanyuan Zhang ◽  
...  

PURPOSE: To evaluate 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 and October 2020 in our unit. All patients were preoperatively evaluated with urine analysis, serum biochemistry, urinary ultrasonography, non-contrast computed tomography and intravenous urography. The procedure was considered as successful in patients with complete stone disappearance or fragments <  4 mm on B ultrasound or computed tomography. The operative parameters, postoperative outcomes and complications were recorded and analyzed respectively. RESULTS: The average operative time and postoperative hospital stay were 46.9±15.8 min and 1.2±1.1 days, respectively, among 784 patients. In addition, 746 patients were followed up and 38 patients were lost. In these patients, 700 (93.8%) cases met the stone removal criteria and 46 cases (6.2%) did not meet the stone removal criteria who need further treatment. 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, 68.9%) and lpsilateral low back pain (47/784, 6.0%). 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 limitations to the efficacy in treating larger stone and lower calyceal calculi.

Author(s):  
Wei Tao ◽  
Ming Xu ◽  
Yachen Zang ◽  
Jin Zhu ◽  
Boxin Xue ◽  
...  

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.


Videourology ◽  
2018 ◽  
Vol 32 (4) ◽  
Author(s):  
Shinsuke Okada ◽  
Shuzo Hamamoto ◽  
Takaaki Inoue ◽  
Shingo Minagawa ◽  
Hirofumi Morikawa ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Shimpei Yamashita ◽  
Yasuo Kohjimoto ◽  
Yuya Iwahashi ◽  
Takashi Iguchi ◽  
Satoshi Nishizawa ◽  
...  

Kidney stones are a major public health concern with continuously increasing worldwide prevalence. Shock wave lithotripsy (SWL) is the first line treatment choice for upper urinary tract calculi with ureteroscopy and has advantages of safety and noninvasiveness, but the treatment success rate of SWL is lower than that of other therapies. It is therefore important to identify predictive factors for SWL outcome and select a suitable treatment choice for patients with upper urinary tract calculi. In recent years, computed tomography (CT) has become the gold standard for diagnosis of upper urinary tract calculi. Several factors based on CT images, including skin-to-stone distance, mean stone density, stone heterogeneity index, and variation coefficient of stone density, have been reported to be useful for predicting SWL outcome. In addition, a new method of analysis, CT texture analysis, is reportedly useful for predicting SWL outcomes. This review aims to summarize CT parameters for predicting the outcome of shock wave lithotripsy in stone cases in the upper urinary tract.


2013 ◽  
Vol 12 (1) ◽  
pp. e1061
Author(s):  
Y. Wu ◽  
X. Zou ◽  
R. Xiao ◽  
Y. Yuan ◽  
X. Wang ◽  
...  

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