输尿管镜碎石取石术提高碎石成功率的研究进展

doi:10.3760/cma.j.issn.1007-1245.2022.12.031

摘要/Abstract

摘要： 输尿管镜碎石取石术具有安全性高、结石清除率高、创伤小等优势，是上尿路结石重要的治疗手段。上镜困难和结石上移是导致手术失败的两大关键因素。近年来，伴随输尿管镜的普及和发展，如何提高输尿管镜碎石取石术成功率已经受到临床工作者的重视和研究。该文章通过查阅相关文献对提高输尿管镜碎石取石术成功率的方法进行综述。

关键词: 输尿管镜, 尿路结石, 输尿管开口, 碎石术

Abstract: Ureteroscopic lithotripsy is an important treatment for upper urinary calculi with the advantages of high safety, high stone clearance rate, and little trauma. Photogenic difficulty and calculus upward movement are two key factors leading to surgical failure. In recent years, with the popularization and development of ureteroscopy, how to improve the success rate of ureteroscopic lithotripsy has been paid attention to and studied by clinical workers. This article reviews the methods to improve the success rate of ureteroscopic lithotomy by referring to relevant literatures.

Key words: Ureteroscopy, Urinary calculus, Ureteral opening, Lithotripsy

赵伟, 肖云新, 陈光耀. 输尿管镜碎石取石术提高碎石成功率的研究进展[J]. 国际医药卫生导报, 2022, 28(12): 1764-1767.

Zhao Wei, Xiao Yunxin, Chen Guangyao. Progress in improving the success rate of ureteroscopic lithotripsy [J]. International Medicine and Health Guidance News, 2022, 28(12): 1764-1767.

参考文献

[1] Khan A. Prevalence, pathophysiological mechanisms and factors affecting urolithiasis[J]. Int Urol Nephrol, 2018, 50(5): 799–806. DOI: 10.1007/s11255-018-1849-2.

[2] 米华,邓耀良.中国尿石症的流行病学特征[J]. 中华泌尿外科杂志, 2003, 24(10):715-716. DOI: 10.3760/j:issn:1000-6702.2003.10.021.

[3] Marchini GS, Vicentini FC, Monga M, et al. Irreversible renal function impairment due to silent ureteral stones[J]. Urology, 2016, 93:33-39. DOI: 10.1016/j.urology.2016. 02.042.

[4] 杨逸铭, 张剑锋, 关登海, 等. 逆行输尿管镜手术感染性并发症的预防及策略[J]. 国际医药卫生导报, 2022, 28(4): 582-585. DOI: 10.3760/cma.j.issn.1007-1245.2022. 04.034.

[5] Selmi V, Sarı S, Caniklioğlu M, et al. Effect of endoscopic ureteral stone treatment on kidney function[J].Cureus,2021,13(1):e12883.DOI: 10.7759/cureus.12883.

[6] Elashry OM, Elgamasy AK, Sabaa MA, et al. Ureteroscopic management of lower ureteric calculi: a 15-year single-centre experience[J]. BJU Int, 2008, 102(8): 1010-1017. DOI: 10.1111/j.1464-410X.2008.07747.x.

[7] Oztekin U, Caniklioglu M, Atac F, et al. Comparison of safety and efficiency of general, spinal and epidural anesthesia methods used for the endoscopic surgical treatment of ureteral stones: which one is better to access the ureter and reach the stone?[J]. Urol J, 2020, 17(3): 237-242. DOI: 10.22037/uj.v0i0.5638.

[8] De S, Autorino R, Kim FJ, et al. Percutaneous nephrolithotomy versus retrograde intrarenal surgery: a systematic review and meta-analysis[J]. European Urology, 2015, 67(1): 125-137. DOI: 10.1016/j.eururo. 2014.07.003.

[9] 娄禄, 刘星, 徐觉剑, 等. 局麻下经尿道输尿管镜钬激光碎石治疗妊娠合并输尿管结石25例[J]. 国际泌尿系统杂志, 2017, 37(2): 191-193. DOI: 10.3760/cma.j.issn.1673- 4416.2017.02.008.

[10] Johnson LJ, Davenport D, Venkatesh R. Effects of alpha-blockade on ureteral peristalsis and intrapelvic pressure in an in vivo stented porcine model[J]. J Endourol, 2016, 30(4): 417-421. DOI: 10.1089/end.2015.0251.

[11] Alsaikhan B, Koziarz A, Lee JY, et al. Preoperative alpha-blockers for ureteroscopy for ureteral stones: a systematic review and meta-analysis of randomized controlled trials[J]. J Endourol, 2020, 34(1): 33-41. DOI: 10.1089/end.2019.0520.

[12] Sharma G, Pareek T, Kaundal P, et al. Comparison of efficacy of three commonly used alpha-blockers as medical expulsive therapy for distal ureter stones: a systematic review and network meta-analysis[J]. Int Braz J Urol, 2021, 20: 47. DOI: 10.1590/S1677-5538.IBJU.2020.0548.

[13] Türk C, Petřík A, Sarica K, et al. EAU guidelines on interventional treatment for urolithiasis[J]. Eur Urol,2016,69(3):475-482. DOI:10.1016/j.eururo.2015.07. 041.

[14] Yang Y, Tang Y, Bai Y, et al. Preoperative double-J stent placement can improve the stone-free rate for patients undergoing ureteroscopic lithotripsy: a systematic review and meta-analysis[J]. Urolithiasis, 2018, 46(5): 493-499. DOI: 10.1007/s00240-017-1012-z.

[15] Zhang J, Xu C, He D, et al. Flexible ureteroscopy for renal stone without preoperative ureteral stenting shows good prognosis[J]. PeerJ, 2016, 4: e2728. DOI: 10.7717/peerj.2728.

[16] 周志均,李响. 输尿管软镜碎石术前预置双J管必要性的荟萃分析[J]. 中华泌尿外科杂志,2020,41(2):138-146. DOI:10.3760/cma.j.issn.1000-6702.2020.01.011.

[17] Traxer O, Thomas A. Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery[J]. J Urol,2013,189(2):580-584.DOI: 10.1016/j.juro.2012.08.197.

[18] 杨守东, 肖东明, 司徒杰, 等. 封堵器联合钬激光治疗输尿管中上段结石的临床疗效分析[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2021, 15(6): 511-515. DOI: 10.3877/cma.j.issn.1674-3253.2021.06.014.

[19] 李丽, 徐勇, 齐士勇. 输尿管镜碎石术中防止结石移位策略的研究进展[J]. 天津医药, 2015, 43(7): 822-825. DOI: 10.11958/j.issn.0253-9896.2015.07.033.

[20] Desai MR, Patel SB, Desai MM, et al. The dretler stone cone: a device to prevent ureteral stone migration-the initial clinical experience[J]. J Urol, 2002, 167(5): 1985-1988. DOI: 10.1016/S0022-5347(05)65069-0.

[21] Dellabella M, Milanese G, d'Anzeo G, et al. Rapid, economical treatment of large impacted calculi in the proximal ureter with ballistic ureteral lithotripsy and occlusive, percutaneous balloon catheter: the high pressure irrigation technique[J]. J Urol,2007,178(3Pt1):929-933;discussion933-934. DOI:10.1016/j.juro.2007.05.037.

[22] Pan J, Xue W, Xia L, et al. Ureteroscopic lithotripsy in trendelenburg position for proximal ureteral calculi: a prospective, randomized, comparative study[J]. Int Urol Nephrol, 2014,46(10):1895-1901. DOI: 10.1007/s11255-014-0732-z.

[23] Rehman J, Monga M, Landman J, et al. Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths[J]. Urology, 2003, 61(4): 713-718. DOI: 10.1016/s0090-4295(02)02440-8.

[24] Wu ZH, Liu TZ, Wang XH, et al. Negative-pressure ureteroscopic holmium-yag laser lithotripsy for ureteral stones[J]. Urol Int, 2020, 104(9-10): 752-757. DOI: 10.1159/000507266.

[25] 范地福, 曾旻, 黄永明, 等. 新型负压吸引经尿道输尿管一体硬镜碎石术的临床应用研究[J]. 中国现代医学杂志, 2021,31(11):86-91. DOI: 10.3969/j.issn.1005-8982. 2021.11.016.

[26] 罗钦瑞, 陈洪波. 硕通镜治疗上尿路结石的研究进展[J]. 临床泌尿外科杂志, 2021, 36(6): 502-505, 508. DOI: 10.3969/j.issn.1674-4985.2020.35.017.

[27] 王树声, 翁湘涛, 周均洪, 等. 硕通镜治疗上尿路结石的有效性与安全性[J]. 中华泌尿外科杂志, 2017, 38(9): 671-674. DOI: 10.3760/cma.j.issn.1000-6702.2017. 09.008.

[28] 顾君, 吴海超, 何泽喜, 等. 硕通镜与经皮肾镜取石术治疗上尿路结石的Meta分析[J]. 海南医学, 2021, 32(20): 2708-2715. DOI: 10.3969/j.issn.1003-6350.2021.20.032.

[29] Kronenberg P, Somani B. Advances in lasers for the treatment of stones-a systematic review[J]. Curr Urol Rep, 2018, 19(6): 45. DOI: 10.1007/s11934-018-0807-y.

[30] Fallah Karkan M, Ghiasy S, Ranjbar A, et al. Evaluation of 200 Mm, 365 Mm and 500 Mm fibers of ho:YAG laser in transurethral lithotripsy of ureteral: a randomize control trial[J]. J Lasers Med Sci, 2018, 9(1): 69-72. DOI: 10.15171/jlms.2018.14.

[31] Chen S, Fu N, Cui W, et al. Comparison of stone dusting efficiency when using different energy settings of Holmium: YAG laser for flexible ureteroscopic lithotripsy in the treatment of upper urinary tract calculi[J]. Urol J, 2019, 17(3): 224-227. DOI: 10.22037/uj.v0i0.4955.