The evolution of ureteroscopy: a modern single-institution series.
Mayo Clin Proc
; 81(4): 468-73, 2006 Apr.
Article
em En
| MEDLINE
| ID: mdl-16610566
OBJECTIVES: To evaluate a modern ureteroscopy series, including the use of new technological advances, operative procedures, and potential complications, at a single institution and to compare our current experience with our prior published series and the current literature. MATERIAL AND METHODS: We retrospectively reviewed 1000 consecutive ureteroscopies performed in 961 patients from December 1999 to February 2003 at our institution. RESULTS: Semirigid and flexible ureteroscopes were used in 60.3% and 37.0% of the cases, respectively. In 2.6% of cases, a combination of both rigid and flexible ureteroscopes was required. The most common indications for ureteroscopy were as follows: stone, 57.9%; diagnostic, 20.6%; and urothelial carcinoma, 12.6%. Of the stones treated, 31.8% were proximal or middle and 59.1% distal. The overall, proximal, and distal stone-free rates were 91.7%, 87.3%, and 94.2%, respectively. Average operative time was 81 minutes (range, 5-280 minutes). Average follow-up was 2.36 months (range, 1-24 months). The overall complication rate was 1.9% (18/961), including a 0.2% (2/961) incidence of ureteral strictures. CONCLUSION: Current practice trends have shifted to an increased use of flexible ureteroscopes and more frequent ureteroscopic treatment of proximal calculi. Our single treatment stone-free rates are competitive with quoted shock wave lithotripsy success. In addition, there has been a decrease in ureteroscopic-associated complications in our series, with no ureteral avulsions. The improvements in treatment success and decrease in complications may be secondary to advances in ureteroscopic technology.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Ureterais
/
Ureteroscopia
Tipo de estudo:
Diagnostic_studies
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Evaluation_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Child, preschool
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Mayo Clin Proc
Ano de publicação:
2006
Tipo de documento:
Article
País de afiliação:
Estados Unidos