Analysis Of Application And Complications Of Laser Lithotripsy For Renal Calculi Through Flexible Ureteroscope

Objective:Analysis of the Causes of Septic Shock and Multiple Organ failure (MOF)after Laser Lithotripsy for renal calculi through Flexible Ureteroscope. Method: Retrospective analysis of the severe complications and reliable methods of prevention laser lithotripsy through flexible ureteroscope for the treatment of renal calculi of a total of 21 clinical patients in our department from June to July in 2013. Result:Total of 21 patients with renal calculi treated with laser lithotripsy through flexible ureteroscope. All the crushed stones in the surgery, lithotripsy rate 100%.16 cases of calculi in patients with complete clearance, no residual stone, stone clearance rate was 76.2%,5 cases of patients with renal pelvis with a small amount of crushed stone residue, after January are clear.Of which 17 patients were successfully treated and discharged from hospital within one week. Sepsis and septic shock occured in 4 patients,2 of them progressed into MOF and By the effective fluid resuscitation and after anti-inflammatory treatment 1 patients recovered,2 month after discharge, and one died. All of 4 patients with sepsis septic shock after Laser Lithotripsy through flexible ureteroscope had positive urine culture preoperatively and 3 had large stone (>2 cm) and one had multi-calculi. Operation (lithotripsy) time was longer than 1 hour in all of the 4 patients. Conclusion: preoperative positive urine culture and large stones and long lithotripsy time were the major reasons of sepsis septic shock after Laser Lithotripsy through flexible ureteroscope.Active infection control, improve the general condition, maintenance of water, electrolyte and acid-base balance as much as possible, to improve the nutritional status can prevent blocking pathological chain reaction.