Effect of Holmium Laser Lithotripsy under Transurethral Ureteroscopy on Occurrence of Ureteral Stricture,Oxidative Stress Response and Inflammatory Response in Patients with Ureteral Stones
Objective To investigate the incidence of postoperative ureteral stricture and its impact on oxidative stress and inflammatory response in patients of ureteral stones treated with flexible ureteroscopic lithotripsy(FURL)using Holmium laser lithotripsy under transurethral ureteroscopy.Methods A retrospective analysis was made on the clinical data of 121 patients with upper ureteral stones treated over the period from Dec.2020 to Oct.2022.They were divided into a study group(n=68)and a control group(n=53)by treating methods.The patients in the study group were given FUL(frequency:15-30 Hz,energy:1.0-1.5 J),and those in the control group percutaneous nephrolithotomy(frequency:15-30 Hz,energy:1.0-1.5 J).The clinical indicators and incidence of postoperative complications such as ureteral stenosis were recorded for both groups.Three days after the surgery,the levels of serum cortisol(COR),malondialdehyde(MDA),heme oxygenase-1(HO-1),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)in the blood serum of the patients in both groups were detected.The one-time stone clearance rate was compared between the two groups 3 months after the surgery.The stone recurrence was also compared between the two groups 6 and 12 months after the surgery respectively.Results The surgical time and postoperative hospital stay in the study group were shorter than those in the control group,and the treating cost was lower than that in the control group(P＜0.05).There was no statistically significant difference in the overall incidence of postoperative complications such as ureteral stenosis,renal colic,severe hematuria and fever between the two groups(P＞0.05).Three days after the surgery,the serum COR,MDA,HO-1,IL-10,TNF-α and CRP of both groups were higher than those before the surgery(P＜0.05),but the levels were lower in the study group than in the control group(P＜0.05).There was no statistically significant difference in the recurrence rate of stones between the two groups 12 months after the surgery(P＞0.05).Conclusions The Holmium laser lithotripsy under transurethral ureteroscopy has a good therapeutic effect on patients with ureteral stones with a high stone clearance rate.The incidences of postoperative complications such as ureteral stenosis,oxidative stress response and inflammatory response are relatively low,and the recurrence is rare.For these reasons,it is worthy of clinical promotion and application.
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