203례 요로 결석의 레이져 쇄석기 치료 경험
Laser Lithoripsy on 203 Cases on the Urinary Calculi
한상이, 박흥원,
소속 상세정보
한상이 ( )
한림대학교 의과대학 강남성심병원
박흥원 ( )
한림대학교
KMID : 0358319920330040672
Abstract
From April 1988 to July 1991, 203 cases of urinary stones, including 183 ureteral, 15 bladder and 5 urethral stones, were managed by Candela MDL-1 Laser Lithotriptor under the ureteroscope. The success rates according to location were 68%(17/25)
in
upper ureter, 78.4%(29/37) in mid ureter, 93.4(113/121) in lower ureter and 100%(20/20) in bladder and urethra, and the mean success rate was 88.2%(179/203). The success rates according to stone size were 98.2% (54/55) in below 0.5%cm,
87.6%(92/105) in
0.6=-1.0cm, 75%(24/32) in 1.1-2.0cm and 81.8(9/11) in above 2.1cm. The total cases of failure were 24, and the causes of failure were approach failure or poor visualization and upward migration. 9 cases of failure were managed by retried laser
lithotripsy, 4 by ureterolithotomy and 3 cases were resolved in spontaneous passing. But 8 cases were lost in follow-up. The end mean success rate was 94.1%(191/203). 27 cases of gross hematuria and 34 of colic pain, which persisted more than 48
hours
after operation, were managed conservatively. Also, in 5 cases of ureteral injuries, 2 cases were managed by surgical intervention and 3 by internal ureteral stent. Therefore, laser lithotripsy is a safe, effective and cost-effective single
treatment
modality in lower urinary tract stones. And if it is possible to maintain good visual field and to prevent upward migration, we will get the higher success rate in mid and upper ureteral stones.
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