Comparative study of a variety of minimally invasive surgeries for ureteral calculi of the fourth lumbar vertebrae

doi:10.3877/cma.j.issn.1674-3253.2017.02.011

Abstract

Abstract:

Objective

To explore the minimally invasive means for the treatment of ureteral calculi of the fourth lumbar vertebrae.

Methods

The clinical data of 358 cases were analyzed retrospectively. One hundred and eighty-seven cases were treated by minimally invasive percutaneous nephrolithotomy (MPCNL), 86 cases were treated by transurethral ureteroscopic pneumatic or holmium laser lithotripsy(URL), 23 cases by combination of percutaneous nephrostomy and transurethral ureteroscopic lithotripsy, 62 cases were treated by retrograde intra-renal surgery (RIRS). The efficacy and complications were compared.

Results

The stone-free rate of one time was 96.3%, 90.7%, 100% and 100%, respectively. Residual stones were removed by adjuvant therapy. Fastest recovery and shortest hospital stay was observed in RIRS group. No severe complication were noted during 1 to 28 months follow-up.

Conclusion

MPCNL, URL, combination of percutaneous nephrostomy and transurethral ureteroscopic lithotripsy, and RIRS are common treatments for ureteral calculi of the fourth lumbar vertebrae. Combination of percutaneous nephrostomy and transurethral ureteroscopy can be applied for some refractory cases. With the development of RIRS, RIRS is the first choice of ureteral calculi of the fourth lumbar vertebrae with mild to moderate hydronephrosis.

Key words: Percutaneous nephrolithotomy, Ureteroscopy, Flexible ureteroscope, Ureteral calculi

Zhenyu Cui, Wenzeng Yang, Hongyue Zhou, Ruojing Wei, tao Ma, Wei Zhang, Yu Li, Xiaoqiang Shi. Comparative study of a variety of minimally invasive surgeries for ureteral calculi of the fourth lumbar vertebrae[J]. Chinese Journal of Endourology(Electronic Edition), 2017, 11(02): 122-125.

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References 15

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组别	例数	年龄（岁，±s）	性别（例）		结石大小（cm，±s）	一次清石率[例（%）]	住院时间（d，，±s）
组别	例数	年龄（岁，±s）	男	女	结石大小（cm，±s）	一次清石率[例（%）]	住院时间（d，，±s）
MPCNL组	187	50±7	100	87	1.2±0.6	180（96.3）	8.0±0.5
URL组	86	54±8	52	34	1.1±0.5	78（90.7）	6.0±0.5
经皮肾穿刺造瘘联合经尿道输尿管镜组	23	51±7	12	11	1.3±0.6	100	7.0±0.5
RIRS组	62	53±4	34	28	1.3±0.7	100	3.5±0.5
统计值	?	2.015	1.276		1.601	9.409	1326.551
P值	?	0.162	0.735		0.329	0.024	<0.001

组别	例数	年龄（岁，±s）	性别（例）		结石大小（cm，±s）	一次清石率[例（%）]	住院时间（d，，±s）
组别	例数	年龄（岁，±s）	男	女	结石大小（cm，±s）	一次清石率[例（%）]	住院时间（d，，±s）
MPCNL组	187	50±7	100	87	1.2±0.6	180（96.3）	8.0±0.5
URL组	86	54±8	52	34	1.1±0.5	78（90.7）	6.0±0.5
经皮肾穿刺造瘘联合经尿道输尿管镜组	23	51±7	12	11	1.3±0.6	100	7.0±0.5
RIRS组	62	53±4	34	28	1.3±0.7	100	3.5±0.5
统计值	?	2.015	1.276		1.601	9.409	1326.551
P值	?	0.162	0.735		0.329	0.024	<0.001

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