Clinical evaluation of digital flexible ureteroscopy with holmium laser lithotripsy for renal calculi in solitary kidneys

Abstract

Objectives To explore the clinical value of digital flexible ureteroscopy with holmium laser lithotripsy in the treatment of renal calculi in solitary kidneys.Methods Date of 39 cases of renal calculi in solitary kidneys treated with Olympus e-flexible ureteroscope with holmium laser lithotripsy in our department were retrospectively analyzed.20 of the cases were multiple stones in the renal pelvis and calyx,4 were solitary kidney infection calculi,1 o were calyx diverticulum stones,4 were impacted calycolithiasis,and 1 were multiple submucosal calcification.Ureteroscopy was conducted.Guide wires were indwelt and F12-14 ureteral dilatation sheath was placed.After the flexible ureteroscope entered the pelvis,renal pelvis and upper,middle and lower calyx were observed to locate the calculi.365 um or 200 um fiber was chosen according to stone location,and the power ranged between 0.5 ～ 1Jand 15 ～ 30Hz.Stones were completely smashed to 2mm.If ureteral sheath was placed,stone could be removed or partially removed with flush drainage or stone-bag.Double-J tube was indwelt in all patients for two weeks.The first day after the operation catheter was removed.4 weeks after the surgery,KUB or CT was performed to assess the stone excretion rate.Results 34 of 39 cases(87.2％) had successful placement of ureteral sheaths,and all cases had ureteroscope entered successfully and located the calculi.33cases had no stone residual or stone residuals ＜4mm after the first operation.Conclusions Providing clear vision,digital flexible ureteroscope is safe and minimal invasive.Combined with holmium laser,it can be used in the treatment of all types of renal calculi in solitary kidneys. Key words: Kidney Calculi ; Lasers, Solid-State; Ureteroscopes