Staged flexible ureteroscopy with holmium laser lithotripsy for the treatment of diameter ≥4 cm complex nephrolithiasis: a retrospective study of 389 cases

Deng Guoxian, Xia Xiaowen, Yan Jun’an

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Journal of Chongqing Medical University ›› 2024, Vol. 49 ›› Issue (06) : 665-668. DOI: 10.13406/j.cnki.cyxb.003512
Urinary system calculi

Staged flexible ureteroscopy with holmium laser lithotripsy for the treatment of diameter ≥4 cm complex nephrolithiasis: a retrospective study of 389 cases

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Abstract

Objective To investigate the safety and efficacy of staged flexible ureteroscopy with holmium laser lithotripsy（FURL）for the treatment of complex nephrolithiasis. Methods We retrospectively analyzed 389 patients with unilateral large renal stones（≥4 cm in diameter）who had undergone staged FURL from January 2013 to December 2023. We analyzed the number and duration of procedures performed，the length of hospital stay，the cost of hospitalization，the stone clearance rate，and the incidence of complications（fever，urosepsis，severe hemorrhage，steinstrasse，etc.）. Results Each patient underwent at least two procedures，and 22 patients underwent three procedures. The mean duration of stage-1 procedures was（84.60±21.34） minutes. The mean duration of stage-2 procedures was （89.70±19.17） minutes，with a stone clearance rate of 94.60%. The mean duration of stage-3 procedures was （72.50±17.30） minutes，with a stone clearance rate of 90.90%. There were 21 events of fever（7 cases of urosepsis），76 events of steinstrasse，and 30 events of gross hematuria. Conclusion Staged FURL is safe and effective for treating large stones in the kidney，but its high cost is a concern to the patients.

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flexible ureteroscopy / staged / nephrolithiasis

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Deng Guoxian , Xia Xiaowen , Yan Jun’an. Staged flexible ureteroscopy with holmium laser lithotripsy for the treatment of diameter ≥4 cm complex nephrolithiasis: a retrospective study of 389 cases. Journal of Chongqing Medical University. 2024, 49(06): 665-668 https://doi.org/10.13406/j.cnki.cyxb.003512

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