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Comparison of two endoscopies used in upper ureteral calculi with moderate and severe hydronephrosis in renal pelvis |
SHEN Ze, ZHANG Chunping, LI Chenghong, ZHANG Qinmei |
Department of First Surgery, Yunnan Provincial Baoshan Hospital, Chinese People’s Armed Police Forces, Baoshan 678000, China |
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Abstract Objective To compare two endoscopies used in upper ureteral calculi with moderate and severe hydronephrosis in renal pelvis. Methods Sixty patients with upper ureteral calculi complicated by middle-high grade nephrohydrops were randomly divided into two groups, the percutaneous flexible ureteroscopy group (flexible ureteroscopy group) and the percutaneous rigid ureteroscopy group (rigid ureteroscopy group), 30 patients in each group. The range between infrascapular line and postaxillary line under the eleventh or twelfth rib were as puncture point, and then the target renal calculi were seeked under the ultrasound guidance. In flexible ureteroscopy group, the renal calculi and ureter were seeked by flexible ureteroscopy through the peel-away sheath anterograde mehtod, and then holmium laser lithotripsy was performed for the ureteral calculi. In rigid ureteroscopy group,the seeking procedures were performed by rigid ureteroscopy, and the method was the same as the flexible ureteroscopy group. Results In flexible ureteroscopy group, the lithagogue rate was 93.3% (28/30), that in rigid ureteroscopy group was 70% (21/30), the former was higher than the latter, the difference was statistically significant(χ2=5.45,P=0.0195). In flexible ureteroscopy group, the operation time was (67±15) min, in rigid ureteroscopy group (51±13) min, the difference was statistically significant (t=2.35,P=0.0250). Two patients in flexible ureteroscopy group (6.7%) had fever after surgery, three patients in rigid ureteroscopy group (10%) had fever, the difference between the two groups was not statistically significant. Conclusions There were fewer complications and higher stone free-rates in the patients with upper ureteral calculi complicated by middle-high grade nephrohydrops, by using percutaneous anterograde flexible lithotripsy.
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Received: 10 February 2015
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