Comparison of the efficacy of ureteroscopic holmium laser lithotripsy and retroperitoneal laparoscopic ureterolithotomy in the treatment of middle and upper ureteral calculi
Objective To compare the clinical efficacy of ureteroscopic holmium laser lithotripsy (UHLL) and retroperitoneal laparoscopic ureterolithotomy (RLU) in the treatment of middle and upper ureteral calculi. Methods 70 patients with middle and upper ureteral calculi were divided into UHLL group (n=35) and RLU group (n=35) according to different surgical methods. The perioperative indexes,inflammatory indexes,complications,and stone removal effect and were compared between the two groups. Results The amount of intraoperative blood loss of (5.31±0.59) ml in UHLL group was less than (12.35±2.12) ml in RLU group;the operation time and length of hospital stay were (54.25±14.13) min and (4.22±0.75) d in UHLL group,which were shorter than (72.52±15.26) min and (6.21±0.86) d in RLU group (P<0.05). 1 d before surgery,there were no significant differences in the levels of interleukin-6 (IL-6),procalcitonin (PCT) and C-reactive protein (CRP) between RLU group and UHLL group (P>0.05). 1 d after surgery,the levels of IL-6,PCT and CRP in UHLL group were slightly higher than those in RLU group,but there was no statistical difference (P>0.05). The incidence of postoperative complications in UHLL group was 8.57％,which was slightly higher than 2.86％ in RLU group,but there was no statistical difference (P>0.05). After 6-12 months of follow-up,the stone removal rate of RLU group and UHLL group were 100.00％ and 97.14％,and there was no statistical difference (P>0.05). Conclusion Both UHLL and RLU have relatively reliable effects and safety in the treatment of middle ureteral calculi,but the former has short operation time,less amount of intraoperative blood loss and quick postoperative recovery,and the upper ureteral calculi may migrate up the renal pelvis,so RLU should be selected.
万方数据
维普
