Abstract：
OBJECTIVE: To compare the efficacy of Holmium laser lithotripsy with that of extracorporeal shock lithotripsy (SWL) for post-SWL ureteral steinstrasse.
METHODS: From January 2022 to July 2023, 36 patients with post-SWL ureteral steinstrasse were randomly divided into laser lithotripsy and SWL groups. Patients with pain, moderate to marked hydronephrosis, large leading stone fragments, and showing no spontaneous resolution within 3-4 weeks after medical expulsive therapy were included. Patients with sepsis were excluded. The success rate was the primary outcome. We compared the perioperative data between the groups.
RESULTS: The success rate was higher in the ureteroscopy group than in the SWL group (p = 0.034). SWL was a significantly longer operation, and the fluoroscopy time was significantly longer in the SWL group than in the URS group (p = 0.027). Auxiliary procedures were more frequently performed in the SWL group than in the URS group (p = 0.02). JJ stents were inserted in 100% of patients in the URS group. Three patients (16.7%) underwent conversion to laser ureteroscopy after the second SWL session failed. No significant difference in the incidence of postoperative complications was observed between the groups, but the incidence of postoperative LUT was high in the ureteroscopy group. The mean hospital stay was 30 h in the ureteroscopy group. SWL was performed without the need for hospital admission.
CONCLUSIONS: Ureteroscopic laser lithotripsy for steinstrasse was safe and effective, with a higher success rate, shorter fluoroscopy time, and shorter recovery period than SWL.
METHODS: From January 2022 to July 2023, 36 patients with post-SWL ureteral steinstrasse were randomly divided into laser lithotripsy and SWL groups. Patients with pain, moderate to marked hydronephrosis, large leading stone fragments, and showing no spontaneous resolution within 3-4 weeks after medical expulsive therapy were included. Patients with sepsis were excluded. The success rate was the primary outcome. We compared the perioperative data between the groups.
RESULTS: The success rate was higher in the ureteroscopy group than in the SWL group (p = 0.034). SWL was a significantly longer operation, and the fluoroscopy time was significantly longer in the SWL group than in the URS group (p = 0.027). Auxiliary procedures were more frequently performed in the SWL group than in the URS group (p = 0.02). JJ stents were inserted in 100% of patients in the URS group. Three patients (16.7%) underwent conversion to laser ureteroscopy after the second SWL session failed. No significant difference in the incidence of postoperative complications was observed between the groups, but the incidence of postoperative LUT was high in the ureteroscopy group. The mean hospital stay was 30 h in the ureteroscopy group. SWL was performed without the need for hospital admission.
CONCLUSIONS: Ureteroscopic laser lithotripsy for steinstrasse was safe and effective, with a higher success rate, shorter fluoroscopy time, and shorter recovery period than SWL.
摘要：
目的：比较钬激光碎石术与体外冲击碎石术（SWL）对SWL后输尿管蒸汽碎石术的疗效。
方法：自2022年1月至2023年7月，将36例SWL后输尿管结石患者随机分为激光碎石组和SWL组。疼痛患者,中度至显著肾积水,大的主要石头碎片，并显示在药物治疗后3-4周内无自发消退。排除脓毒症患者。成功率是主要结果。我们比较了组间的围手术期数据。
结果：输尿管镜组的成功率高于SWL组（p=0.034）。SWL是一个明显更长的手术，SWL组的透视时间明显长于URS组(p=0.027).与URS组相比，SWL组的辅助手术频率更高（p=0.02）。在URS组中100%的患者中插入JJ支架。在第二次SWL治疗失败后，三名患者（16.7％）接受了激光输尿管镜检查。术后并发症发生率组间差异无统计学意义,但输尿管镜组术后LUT的发生率较高.输尿管镜组的平均住院时间为30小时。在不需要入院的情况下进行SWL。
结论：输尿管镜下激光碎石术是安全有效的，成功率更高，更短的透视时间，恢复期比SWL短。
方法：自2022年1月至2023年7月，将36例SWL后输尿管结石患者随机分为激光碎石组和SWL组。疼痛患者,中度至显著肾积水,大的主要石头碎片，并显示在药物治疗后3-4周内无自发消退。排除脓毒症患者。成功率是主要结果。我们比较了组间的围手术期数据。
结果：输尿管镜组的成功率高于SWL组（p=0.034）。SWL是一个明显更长的手术，SWL组的透视时间明显长于URS组(p=0.027).与URS组相比，SWL组的辅助手术频率更高（p=0.02）。在URS组中100%的患者中插入JJ支架。在第二次SWL治疗失败后，三名患者（16.7％）接受了激光输尿管镜检查。术后并发症发生率组间差异无统计学意义,但输尿管镜组术后LUT的发生率较高.输尿管镜组的平均住院时间为30小时。在不需要入院的情况下进行SWL。
结论：输尿管镜下激光碎石术是安全有效的，成功率更高，更短的透视时间，恢复期比SWL短。
