Comparison of effects of titanium laser lithotripsy under flexible ureteroscope and rigid ureteroscope in treatment of patients with complex upper ureteral calculi
Objective:To compare effects of titanium laser lithotripsy under flexible ureteroscope and rigid ureteroscope in treatment of patients with complex upper ureteral calculi.Methods:The clinical data of 188 patients with complex upper ureteral calculi admitted to this hospital from July 2021 to February 2023 were retrospectively analyzed.According to the different surgical methods,they were divided into soft ureteroscope group(n=94)and rigid ureteroscope group(n=94).The flexible ureteroscope group was treated with Holmium laser lithotripsy under flexible ureteroscope,while the rigid ureteroscope group was treated with titanium laser lithotripsy under rigid ureteroscope.The levels of perioperative indexes and oxidative stress indexes[serum cortisol(Cor),epinephrine(E),norepinephrine(NE)]before and after the surgery,and the incidence of complications were compared between the two groups.Results:The operation time and the hospitalization time of the soft ureteroscope group were shorter than those of the rigid ureteroscope group,the intraoperative blood loss was less than that of the rigid ureteroscope group,the success rate of lithotripsy was higher than that of the rigid ureteroscope group,the stone migration rate was lower than that of the rigid ureteroscope group,and the differences were statistically significant(P＜0.05).3 days after the surgery,the levels of E,NE and Cor in the two groups were higher than those before the treatment,those in the soft ureteroscope group were lower than those in the rigid ureteroscope group,and the differences were statistically significant(P＜0.05).Further,the incidence of complications in the soft ureteroscope group was 4.26%(4/94),which was lower than 12.77%(12/94)in the rigid ureteroscope group,and the difference was statistically significant(P＜0.05).Conclusions:Holmium laser lithotripsy under flexible ureteroscope in the treatment of the patients with complex upper ureteral calculi can improve the success rate of lithotripsy,improve the levels of perioperative indexes,reduce the body's oxidative stress response,and reduce the stone migration rate and the incidence of complications.Moreover,it is superior to Holmium laser lithotripsy under rigid ureteroscope.
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