요관 Access Sheath를 이용한 요관경하배석술의 유용성
Efficacy of Ureteroscopic Removal of Stones with an Ureteral Access Sheath for the Treatment of Ureteral Calculi
현창호, 송필현, 김현태, 정희창,
소속 상세정보
현창호 ( Hyun Chang-Ho )
영남대학교 의과대학 비뇨기과학교실
송필현 ( Song Phil-Hyun )
영남대학교 의과대학 비뇨기과학교실
김현태 ( Kim Hyun-Tae )
영남대학교 의과대학 비뇨기과학교실
정희창 ( Jung Hee-Chang )
영남대학교 의과대학 비뇨기과학교실
KMID : 0358320090500040355
Abstract
Purpose: The ureteral access sheath (UAS) was developed to facilitate difficult ureteroscopic procedures. However, some have questioned the safety of the UAS and its likelihood of causing significant ureteral traumas. We evaluated the efficacy and safety of a UAS for managing ureteral calculi.
Materials and Methods: From July 2005 to June 2008, a total of 122 patients underwent ureteroscopic removal of stones (67 patients with UAS, 55 patients without UAS). Under local, spinal, or general anesthesia, all patients were treated by using a semirigid ureteroscope with or without UAS. The operative results of the patients were assessed with KUB, and excretory urography or ultrasonography were assessed postoperatively after 2 to 4 weeks. We also analyzed the success rates of stone removal and the complication rates for each procedure.
Results: Mean stone size and mean operation time were 9.3 mm and 38.8 minutes, respectively, with UAS and 8.9 mm and 40.4 minutes, respectively, without UAS. Overall stone-free rates were 89.6% and 76.4%. Mean hospital stay was 2.0 days and 2.2 days. The time for operation was significantly decreased for upper ureteral stones treated with UAS (p= 0.022). The stone-free rates were higher for upper ureteral stones treated with UAS (28/32, 87.5%, p=0.027), especially for stones greater than 10 mm in size (p=0.048).
Conslusions: The use of UAS is effective and safe. The stone-free rates of ureteroscopic removal of stones with UAS were significantly higher than the rates without UAS for large (≥10 mm) upper ureteral calculi.
키워드
Ureteral calculi;Ureteroscopy;Equipment and supplies
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