Efficacy and safety of Ho:YAG Laser Lithotripsy for ureteroscopic removal of proximal and distal ureteral calculi

BMC Urology

Research Article

Christian Stief¹  Wael Y Khoder¹  Raphaela Waidelich¹  Markus Bader¹  Ronald Sroka² 

[1] Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Marchioninistrasse 15, D - 81377, Munich, Germany;Laser Research Laboratory/LIFE Center, Ludwig-Maximilians-University, Munich, Germany;

关键词: Ureteral calculi;    Ureteroscopy;    Holmium-YAG laser;    Lithotripsy;   

DOI  :  10.1186/1471-2490-14-62

 received in 2014-02-11, accepted in 2014-07-30,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundLaser lithotripsy is an established endourological modality. Ho:YAG laser have broadened the indications for ureteroscopic stone managements to include larger stone sizes throughout the whole upper urinary tract. Aim of current work is to assess efficacy and safety of Ho:YAG laser lithotripsy during retrograde ureteroscopic management of ureteral calculi in different locations.Methods88 patients were treated with ureteroscopic Ho:YAG laser lithotripsy in our institute. Study endpoint was the number of treatments until the patient was stone-free. Patients were classified according to the location of their stones as Group I (distal ureteric stones, 51 patients) and group II (proximal ureteral stones, 37). Group I patients have larger stones as Group II (10.70 mm vs. 8.24 mm, respectively, P = 0.020).ResultsOverall stone free rate for both groups was 95.8%. The mean number of procedures for proximal calculi was 1.1 ± 0.1 (1–3) and for distal calculi was 1.0 ± 0.0. The initial treatment was more successful in patients with distal ureteral calculi (100% vs. 82.40%, respectively, P = 0.008). No significant difference in the stone free rate was noticed after the second laser procedure for stones smaller versus larger than 10 mm (100% versus 94.1%, P = 0.13). Overall complication rate was 7.9% (Clavien II und IIIb). Overall and grade-adjusted complication rates were not dependant on the stone location. No laser induced complications were noticed.ConclusionsThe use of the Ho:YAG laser appears to be an adequate tool to disintegrate ureteral calculi independent of primary location. Combination of the semirigid and flexible ureteroscopes as well as the appropriate endourologic tools could likely improve the stone clearance rates for proximal calculi regardless of stone-size.

【 授权许可】

CC BY   
© Khoder et al.; licensee BioMed Central Ltd. 2014