Curative effect observation of holmium laser internal incision along with balloon dilatation in patients with ureteral stricture after operation of impacted ureteric calculi

doi:10.3877/cma.j.issn.1674-3253.2017.06.004

Abstract

Abstract:

Objective

To evaluate the clinical efficacy between balloon dilatation and holmium laser in combination with balloon dilatation in the treatment of ureteral stenosis after surgical removal of impacted ureteral calculi.

Methods

Clinical data of 60 patients presenting with ureteral stenosis after surgical removal of impacted ureteral calculi in Lanzhou General Hospital of Lanzhou Military Area Command between February 2011 and April 2015 were retrospectively analyzed. Among them, 35 patients underwent balloon dilatation (the dilatation group) and 25 received holmium laser combined with balloon dilatation (the combined group). Clinical efficacy was assessed by comparing the effective rate, the degree of renal collecting system separation and ureteral width between the two groups.

Results

No statistical significance was noted in the baseline data between the two groups. All 60 patients successfully completed the surgery. In the dilatation group, the effective rate was significantly lower than the combined group (54.3% vs 80.0%, P<0.05). In the dilatation group, preoperative and postoperative values of renal collecting system separation were (3.8±0.5) cm and (2.5±0.5) cm with statistical significance (P<0.05), and the ureteral width was (2.5±0.9) mm and (3.8±0.4) mm with statistical significance (P<0.05), whereas no statistical significance was observed in the preoperative and postoperative length of ureteral stenosis [(1.2±0.3) cm vs (0.9±0.5) cm, P>0.05)]. In the combined group, the value of renal collecting system separation [(3.7±0.6) cmvs (2.0±0.8) cm], ureteral width [(2.3±0.7) cm vs (19.5±0.8) mm] and ureteral length [(1.1±0.5) cm vs (0.5±0.3) cm] significantly differed before and after surgery (all P<0.05). Postoperative ureteral width, ureteral length and the value of renal collecting system separation significantly differed between thetwo groups (all P<0.05).

Conclusion

Compared with balloon dilatation alone, holmium laser in combination with balloon dilatation yields higher clinical efficacy in the treatment of ureteral stenosis after surgical removal of impacted ureteral calculi.

Key words: Ureteral calculi, Holmium laser, Balloon dilatation, Ureteral stenosis

Zhonglin Cai, Wenjuan Li, Chuan Zhou, Xupan Wei, Fenghai Zhou. Curative effect observation of holmium laser internal incision along with balloon dilatation in patients with ureteral stricture after operation of impacted ureteric calculi[J]. Chinese Journal of Endourology(Electronic Edition), 2017, 11(06): 372-375.

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Figures/Tables 3

References 15

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组别	例数	性别（例）		年龄（岁，±s）	输尿管狭窄部位（例）					输尿管狭窄长度（cm，±s）	输尿管狭窄宽度（cm，±s）
组别	例数	男	女	年龄（岁，±s）	左	右	上段	中段	下段	输尿管狭窄长度（cm，±s）	输尿管狭窄宽度（cm，±s）
扩张组	35	25	10	44±11	15	20	16	10	9	1.2±0.3	0.25±0.09
联合组	25	18	07	42±11	11	14	12	08	5	1.1±0.5	0.23±0.07
统计值	-	χ²=0.002		t=0.694	0.008		χ²=0.278			0.449	t=0.928
P值	-	0.961		0.490	0.930		0.870			0.660	0.357
组别	碎石手术方式（例）				肾功能受损程度（例）			肾集合系统分离（cm，±s）
组别	钬激光碎石术	体外冲击波碎石术	经腹腔镜输尿管切开取石术	超声气压弹道碎石术	轻	中	重	肾集合系统分离（cm，±s）
扩张组	22	4	3	6	8	16	11	3.8±0.5
联合组	18	3	0	4	5	11	09	3.7±0.6
统计值	χ²=2.341				Z=-0.388			t=0.702
P值	0.505				0.698			0.485

组别	例数	性别（例）		年龄（岁，±s）	输尿管狭窄部位（例）					输尿管狭窄长度（cm，±s）	输尿管狭窄宽度（cm，±s）
组别	例数	男	女	年龄（岁，±s）	左	右	上段	中段	下段	输尿管狭窄长度（cm，±s）	输尿管狭窄宽度（cm，±s）
扩张组	35	25	10	44±11	15	20	16	10	9	1.2±0.3	0.25±0.09
联合组	25	18	07	42±11	11	14	12	08	5	1.1±0.5	0.23±0.07
统计值	-	χ²=0.002		t=0.694	0.008		χ²=0.278			0.449	t=0.928
P值	-	0.961		0.490	0.930		0.870			0.660	0.357
组别	碎石手术方式（例）				肾功能受损程度（例）			肾集合系统分离（cm，±s）
组别	钬激光碎石术	体外冲击波碎石术	经腹腔镜输尿管切开取石术	超声气压弹道碎石术	轻	中	重	肾集合系统分离（cm，±s）
扩张组	22	4	3	6	8	16	11	3.8±0.5
联合组	18	3	0	4	5	11	09	3.7±0.6
统计值	χ²=2.341				Z=-0.388			t=0.702
P值	0.505				0.698			0.485

组别	例数	总体有效率	治疗有效率
组别	例数	总体有效率	钬激光碎石术	体外冲击波碎石术	经腹腔镜输尿管切开取石术	超声气压弹道碎石术
扩张组	35	19(54.3)	11/22(50.0)	2/4(50.0)	2/3(66.7)	4/6(66.7)
联合组	25	20(80.0)	15/18(83.3)	1/3(33.3)	0/0(0)	2/4(50.0)
χ²值	-	4.239	4.835	-	-	-
P值	-	0.040	0.028	1.000	-	1.000

组别	例数	总体有效率	治疗有效率
组别	例数	总体有效率	钬激光碎石术	体外冲击波碎石术	经腹腔镜输尿管切开取石术	超声气压弹道碎石术
扩张组	35	19(54.3)	11/22(50.0)	2/4(50.0)	2/3(66.7)	4/6(66.7)
联合组	25	20(80.0)	15/18(83.3)	1/3(33.3)	0/0(0)	2/4(50.0)
χ²值	-	4.239	4.835	-	-	-
P值	-	0.040	0.028	1.000	-	1.000

组别	例数	输尿管狭窄段宽度	输尿管狭窄段长度	肾集合系统分离
扩张组	35	0.38±0.04	0.9±0.5	2.5±0.5
联合组	25	0.53±0.06	0.5±0.3	1.9±0.8
t值	?	11.626	3.563	3.572
P值	?	<0.001	<0.001	<0.001

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