The Management Of Upper Urinary Tract Calculi With 211 Cases

Objective: Evaluate the efficacy of different modalities in the management of upper urinary tract calculi. Method: the information of 211 cases of upper urinary tract calculi which were treated by Extracorporeal shock wave lithotripsy(ESWL), Ureteroscopic lithotripsy (URL),mini-incision open procedure, Endoscopy applicated open procedure, and open surgery was analyzed retrospectively. Result: Among 211 cases 86 cases were treated by ESWL, 15 cases by URL, 15 cases by mini-incision open procedures, 19 cases by Endoscopy applicated open surgery, and 76 cases by traditional open surgery. Respectively 41%,7%, 7%, 9% and 36%. The stone free rate after ESWL was (60/86)70% at 1 month, (66/86)77% at 2 month. There were 3 stainstress after ESWL, and were rendered stone free with URL or open procedures. The stone free rate of URL was 73%, There was no ureteral perforation and avulsion happened. The stone free rate of mini-incision open procedure was 87%, no transfusion required. 90% stone free rate for Endoscopy applicated open procedures, There was no avulsion of the renal cortex. The stone free rate of traditional open surgery was 86%, 7(9%) cases was required transfusion. Conclusion: Upper urinary tract calculi can be managed by Endourologic techniques and ESWL, minimal incision procedures and open surgery combined with endoscope, can improve the stone free rate of complicated upper tract calculi.