"The direct method" flexible ureteroscopic lithotripsy for the treatment of elderly patients with incarcerated upper ureteral calculi

doi:10.3877/cma.j.issn.1674-3253.2021.03.012

Abstract

Abstract:

Objective

To evaluate efficacy and safety of "the direct method" flexible ureteroscopy lithotripsy for the treatment of elderly patients with incarcerated upper ureteral calculi.

Methods

Between February 2014 and February 2019, in First people's Hospital of Jiujiang 86 cases of elderly patients with incarcerated upper ureteral calculi treated with flexible ureteroscopy were divided into 2 groups by random number including "the direct method" group (43 cases), 23 males and 20 females. The average age was (67±5) years. The maximal stone diameter was (14.7±4.0 )mm. And "two step method" group (43 cases), 26 males and 17 females. The average age was (68±3) years. The maximal stone diameter was (15.3±3.6)mm.The mean operation time, length of hospital stay, surgical complications, 24 hours postoperatively serum creatinine elevation value and stone-free rate were compared between two groups.

Results

The mean operation time in the direct method group was (38.4±11.3) min. The mean operation time in two step method group was (59.6±12.5) min. The difference was statistically significant (P<0.05). The incidence of complications in the direct method group was 13.9%, significantly lower than 25.6% in two step method group (P<0.05). The length of hospital stay, 24 hours postoperatively serum creatinine elevation value and stone-free rate were not statistically different between the two groups (P>0.05).

Conclusions

"The direct method" flexible ureteroscopy lithotripsy is safe and effective for elderly patients with incarcerated upper ureteral calculi.

Key words: Flexible ureteroscopy, Incarcerated, ureteral calculi, Elderly

Xungang Li, Wensheng Zhang, Xingang Cui, Xiaoping Yan. "The direct method" flexible ureteroscopic lithotripsy for the treatment of elderly patients with incarcerated upper ureteral calculi[J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(03): 233-236.

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References 18

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组别	例数	性别(例)		年龄[岁，(±s)]	体质量指数[kg/m²，(±s)]	血清肌酐[μmol/L，(±s)]	结石位置(例)		结石最大径[mm，(±s)]	肾积水程度(例)
组别	例数	男	女	年龄[岁，(±s)]	体质量指数[kg/m²，(±s)]	血清肌酐[μmol/L，(±s)]	左侧	右侧	结石最大径[mm，(±s)]	轻度	中度
直接法组	43	23	20	67±5	24.2±1.1	88.7±3.3	19	24	14.7±4.0	17	26
分步法组	43	26	17	68±3	23.1±1.4	90.1±5.7	22	21	15.3±3.6	19	24
统计值	-	χ²=0.427		t=0.526	t=1.218	t=1.881	χ²=0.420		t=0.815	χ²=0.191
P值	-	0.514		0.601	0.226	0.065	0.517		0.418	0.662

组别	例数	性别(例)		年龄[岁，(±s)]	体质量指数[kg/m²，(±s)]	血清肌酐[μmol/L，(±s)]	结石位置(例)		结石最大径[mm，(±s)]	肾积水程度(例)
组别	例数	男	女	年龄[岁，(±s)]	体质量指数[kg/m²，(±s)]	血清肌酐[μmol/L，(±s)]	左侧	右侧	结石最大径[mm，(±s)]	轻度	中度
直接法组	43	23	20	67±5	24.2±1.1	88.7±3.3	19	24	14.7±4.0	17	26
分步法组	43	26	17	68±3	23.1±1.4	90.1±5.7	22	21	15.3±3.6	19	24
统计值	-	χ²=0.427		t=0.526	t=1.218	t=1.881	χ²=0.420		t=0.815	χ²=0.191
P值	-	0.514		0.601	0.226	0.065	0.517		0.418	0.662

组别	例数	手术时间(min)	住院时间(d)	术后24 h血清肌酐值(μmol/L)	一期结石清除率[例(%)]	并发症(例)	严重出血(例)	术后高热(例)	尿源性脓毒血症(例)	感染性休克(例)	输尿管假道穿孔(例)	输尿管狭窄(例)
直接法组	43	38±11	5.1±1.3	91±4	38(87.7)	6	0	3	1	0	0	2
分步法组	43	59±12	5.6±1.2	91±5	36(84.5)	11	1	5	2	1	2	3
统计值	-	t=10.355	t=1.490	t=0.848	χ²=0.387	χ²=4.914	-	χ²=0.138	-	-	-	-
P值	-	0.000	0.140	0.399	0.534	0.027	0.314	0.710	1.000	1.000	0.474	1.000

组别	例数	手术时间(min)	住院时间(d)	术后24 h血清肌酐值(μmol/L)	一期结石清除率[例(%)]	并发症(例)	严重出血(例)	术后高热(例)	尿源性脓毒血症(例)	感染性休克(例)	输尿管假道穿孔(例)	输尿管狭窄(例)
直接法组	43	38±11	5.1±1.3	91±4	38(87.7)	6	0	3	1	0	0	2
分步法组	43	59±12	5.6±1.2	91±5	36(84.5)	11	1	5	2	1	2	3
统计值	-	t=10.355	t=1.490	t=0.848	χ²=0.387	χ²=4.914	-	χ²=0.138	-	-	-	-
P值	-	0.000	0.140	0.399	0.534	0.027	0.314	0.710	1.000	1.000	0.474	1.000

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