Rigid ureteroscopic lithotripsy in the lateral decubitus position for upper urinary tract stones

BMC Urology

Binbin Li¹  Gang Li²  Zengshi Yang²  Hongbing Zhuo²  Ning Ye²  Jinqing Zhang²  Jingfan Hong³  Yihao Liu⁴ 

[1] Department of Urology, Affiliated Foshan Hospital of SUN Yat-Sen University, The First People’s Hospital of Foshan, Foshan, Guangdong, China;Department of Urology, Affiliated Xiaolan Hospital, Southern Medical University, Zhongshan, Guangdong, China;Department of Urology, Dongguan Kanghua Hospital, Dongguan, Guangdong, China;Department of Urology, Hospital of Traditional Chinese Medicine of Zhongshan, Zhongshan, Guangdong, China;

关键词: Ureteral calculi;    Body position;    Ureteroscopy;    Lithotripsy;    Stone-free rate;   

DOI  :  10.1186/s12894-022-00977-x

来源: Springer

【 摘 要 】

BackgroundThe current study aimed to assess a novel ureteroscopic technique developed for treating upper urinary calculi based on a specially designed lateral decubitus body position that could avoid stone loss by adjusting to the effects of gravity.MethodsThis retrospective study examined patients with upper urinary calculi who were surgically treated from November 2008 to January 2020, using a new body position and a rigid ureteroscope. Clinical outcomes, stone-free rates, operative times and complications were evaluated, and factors that could influence treatment success were determined.ResultsIn total, 1080 patients were included, and 1145 operations were performed. The maximum calculus diameters were 11.22 ± 5.01 mm. Operative times were 48.60 ± 27.44 min. A total of 1042 cases were successfully treated, with a stone-free rate of 91.00%. Multivariate analysis showed that female sex (OR = 2.135, 95% CI 1.332–3.422, P = 0.002), thin scope standby (OR = 1.643, 95% CI 1.074–2.514, P = 0.022), laser lithotripsy (OR = 5.087, 95% CI 2.400–10.785, P = 0.000) and stone size (OR = 0.946, 95% CI 0.912–0.981, P = 0.003) were independently associated with stone-free outcomes. In total, 2 ureteral perforations, 2 ureteric avulsions and 4 urosepsis cases were observed, but were all cured without sequelae.ConclusionsUreteroscopic lithotripsy in the lateral decubitus position is a safe and effective technique for treating upper urinary tract calculi, especially upper ureteral calculi.

【 授权许可】

CC BY