目的:本研究旨在探讨日本上尿路结石行输尿管镜激光碎石术(URS-L)术后输尿管狭窄的并发症和细节。
方法:在2017年4月至2020年3月期间,在日本内分泌学和机器人学会的合作下,回顾性收集了使用URS-L进行输尿管镜检查后的患者数据。数据包括接受URS-L的患者人数,术中和术后并发症的数量和类型,术后输尿管狭窄的详细特点。
结果:总计,在82个机构中,有14125名患者在3年内接受了URS-L。年度URS-L数量从2017年的4419个逐渐增加到2018年的4760个,2019年的4946个。总并发症发生率为10.5%,术中并发症占1.40%,术后并发症占9.18%。年中和术后并发症的发生率在每年之间没有显着差异(p=0.314和p=0.112)。输尿管穿孔,输尿管撕脱,术中转换率为1.35%,0.03%,和0.02%,分别。发烧>38°C,感染性休克,输血,术后死亡率为7.44%,0.81%,0.07%,和0.04%,分别。0.8%的病例发生输尿管狭窄。狭窄部位中位长度为10.0mm,狭窄治疗成功率为54.6%。
结论:尽管URS-L在日本的利用率有所增加,年并发症发生率保持稳定.尽管URS-L是一种有用且侵入性较小的程序,毁灭性的并发症仍然可能发生。
OBJECTIVE: This study aimed to investigate perioperative complications and the details of postoperative ureteral stricture after ureteroscopy with laser lithotripsy (URS-L) for upper urinary tract stones in Japan.
METHODS: Patient data on intra- and postoperative complications after ureteroscopy using URS-L were retrospectively collected from multiple centers in Japan between April 2017 and March 2020 with the cooperation of the Japanese Society of Endourology and Robotics. Data included the number of patients undergoing URS-L, number and type of intra- and postoperative complications, and detailed characteristics of postoperative ureteral stricture.
RESULTS: In total, 14 125 patients underwent URS-L over 3 years at 82 institutions. Annual URS-L numbers gradually increased from 4419 in 2017, to 4760 in 2018, and 4946 in 2019. The total complication rate was 10.5%, which was divided into intra-operative complications in 1.40% and postoperative complications in 9.18%. The annual incidences of intra- and postoperative complications were not significantly different from year to year (p = 0.314 and p = 0.112). Ureteral perforation, ureteral avulsion, and the intra-operative conversion rate were 1.35%, 0.03%, and 0.02%, respectively. Fever >38°C, septic shock, blood transfusion, and postoperative mortality were 7.44%, 0.81%, 0.07%, and 0.04%, respectively. Ureteral stricture occurred in 0.8% of cases. The median length of stricture site was 10.0 mm and the success rate of stricture treatment was 54.6%.
CONCLUSIONS: Although URS-L utilization has increased in Japan, the annual complication rate has remained steady. Although URS-L is a useful and less invasive procedure, devastating complications can still occur.