Differences in Ureteroscopic Stone Treatment and Outcomes for Distal, Mid-, Proximal, or Multiple Ureteral Locations: The Clinical Research Office of the Endourological Society Ureteroscopy Global Study

作者：Perez Castro Enrique; Osther Palle J S; Jinga Viorel; Razvi Hassan; Stravodimos Konstantinos G; Parikh Kandarp; Kural Ali R; de la Rosette Jean J^*

来源：European Urology, 2014, 66(1): 102-109.

DOI：10.1016/j.eururo.2014.01.011

• Ureteroscopy
• Ureteral stones
• Treatment outcome
• Complications

Background: Ureteroscopy has traditionally been the preferred approach for treatment of distal and midureteral stones, with shock wave lithotripsy used for proximal ureteral stones. %26lt;br%26gt;Objective: To describe the differences in the treatment and outcomes of ureteroscopic stones in different locations. %26lt;br%26gt;Design, setting, and participants: Prospective data were collected by the Clinical Research Office of the Endourological Society on consecutive patients treated with ureteroscopy at centres around the world over a 1-yr period. %26lt;br%26gt;Intervention: Ureteroscopy was performed according to study protocol and local clinical practice guidelines. %26lt;br%26gt;Outcome measurements and statistical analysis: Stone location, treatment details, postoperative outcomes, and complications were recorded. Pearson%26apos;s chi-square analysis and analysis of variance were used to compare outcomes among the different stone locations. %26lt;br%26gt;Results and limitations: Between January 2010 and October 2012, 9681 patients received ureteroscopy treatment for stones located in the proximal ureter (n = 2656), midureter (n = 1980), distal ureter (n = 4479), ormultiplelocations (n = 440); locationin126patientswasnot specified. Semirigid ureteroscopy was predominantly used for all stone locations. Laser and pneumatic lithotripsy were used in the majority of cases. Stone-free rates were 94.2% for distal ureter locations, 89.4% for midureter locations, 84.5% for proximal ureter locations, and 76.6% for multiple locations. For the proximal ureter, failure and retreatment rates were significantly higher for semirigid ureteroscopy than for flexible ureteroscopy. A low incidence of intraoperative complications was reported (3.8-7.7%). Postoperative complications occurred in 2.5-4.6% of patients and varied according to location, with the highest incidence reported for multiple stone locations. Limitations include shortterm follow-up and a nonuniform treatment approach. %26lt;br%26gt;Conclusions: Ureteroscopy for ureteral stones resulted in good stone-free rates with low morbidity. %26lt;br%26gt;Patient summary: This study shows that patients who have ureteral stones can be treated successfully with ureteroscopy with a low rate of complications for the patient.

• 出版日期2014-7