背景:输尿管镜检查后的狭窄形成率为0.5%至5%,在输尿管嵌顿结石患者中可能达到24%。输尿管狭窄形成的发病机制尚未完全了解。很可能是患者和结石的特征,以及干预因素,在这个过程中发挥作用。在这次系统审查中,我们的目的是确定输尿管结石嵌顿患者输尿管狭窄形成的潜在因素.
方法:遵循系统评价和荟萃分析(PRISMA)标准的首选报告项目,我们通过PubMed和WebofScience进行了系统的在线研究,没有时间限制,应用关键词“输尿管结石”,“输尿管结石”,“撞击石”,“输尿管狭窄”,“输尿管镜碎石术”,“影响微积分”,和“输尿管狭窄”单独或组合。
结果:取消不合格研究后,我们确定了5篇关于输尿管结石嵌顿性结石治疗后输尿管狭窄形成的文章.逆行输尿管镜检查(URS)治疗输尿管结石后,输尿管穿孔和/或粘膜损伤是输尿管狭窄的关键预测因素。除了输尿管穿孔结石大小,碎石时将结石碎片嵌入输尿管,失败的URS,肾积水程度,肾造瘘管或双J支架(DJS)/输尿管导管插入也是导致输尿管狭窄的因素。
结论:手术过程中输尿管穿孔可能被认为是逆行输尿管镜取石后输尿管狭窄形成的主要危险因素。
BACKGROUND: The
stricture-formation rate following ureteroscopy ranges from 0.5 to 5% and might amount to 24% in patients with impacted ureteral stones. The pathogenesis of ureteral
stricture formation is not yet fully understood. It is likely that the patient and stone characteristics, as well as intervention factors, play a role in this process. In this systematic
review, we aimed to determine the potential factors responsible for ureteral
stricture formation in patients having impacted ureteral stones.
METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) criteria, we conducted systematic online research through PubMed and Web of Science without a time restriction, applying the keywords \"ureteral stone\", \"ureteral calculus\", \"impacted stone\", \"ureteral stenosis\", \"ureteroscopic lithotripsy\", \"impacted calculus\", and \"ureteral strictures\" singly or in combination.
RESULTS: After eliminating non-eligible studies, we identified five articles on ureteral
stricture formation following treatment of impacted ureteral stones. Ureteral perforation and/or mucosal damage appeared as key predictors of ureteral
stricture following retrograde ureteroscopy (URS) for impacted ureteral stones. Besides ureteral perforation stone size, embedded stone fragments into the ureter during lithotripsy, failed URS, degree of hydronephrosis, nephrostomy tube or double-J stent (DJS)/ureter catheter insertion were also suggested factors leading to ureteral strictures.
CONCLUSIONS: Ureteral perforation during surgery might be considered the main risk factor for ureteral stricture formation following retrograde ureteroscopic stone removal for impacted ureteral stones.