Comparison Of The Efficacy Of Ureteroscopic Holmium Laser Incision Versus Ureteroscopic Cold Knife Incision In The Treatment Of Secondary Ureteral Stricture

Objective: We compare the advantages and disadvantages of secondary ureteral stricture by studying retrospectively the two commonly used intracavitary treatment methods of holmium laser and cold knifeincision.Methods:We collected a total of 36 patients with unilateral single-segment secondary ureteral stenosis treated in our department from 2015 to 2018,and retrospectively analyzed.Then according to the different operation methods of the patients were divided into groups,including 21 patients receiving ureteroscopic holmium laser incision,15 patients receiving cold knife incision treatment,The operative time,intraoperative bleeding,postoperative hospital stay,postoperative complications and short-term and long-term effects of the two groups were collected and then statistically analyzed to compare and analyze which operation mode was better.Results: In this study,36 patients were successfully treated by intraluminal treatment in intravenous inhalation combined with anesthesia.The operation time of holmium laser group [(40.2±3.8)min] Intraoperative bleeding [(10.5±5.5)ml]postoperative hospital stay [4.0±1.1)d] were significantly better than cold knife group[(47.4±5.8)min],[(15.5±5.5)ml],[(5.4±1.2)d],the difference was statistically significant(P<0.05).The diameter of secondary ureteral stricture,the degree of proximal dilatation of stenosis,the renal collection system and preoperative comparison between the two groups were statistically significant(P<0.05),indicating that both surgical methods can obtain satisfactory results.Among the laser group,the incidence of complications was 9.52%(2/21)lower than that of the cold knife group25.00%(3/12),and the difference was statistically significant(P<0.05),indicating that there were fewer complications in the holmium laser group.The two groups were followed up for 12 months after pulling out the double J tube.The first and third months,the follow-up results of the two groups showed no significant difference in the total effective rate between the two groups(P >0.05).At the 6th and 12 th months,the total effective rate of holmium laser group was significantly higher than that of cold knife group(P <0.05),statistically significant(P <0.05),indicating that the short-term effect of the two groups was equal,and the long-term effect of holmium laser group was better than that of cold knife incision group.Conclusion: The two methods have the characteristics of safe,effective and quick recovery,but the effect of ureteroscopic holmium laser on ureteral stricture is more remarkable,with short operation time,fast postoperative recovery,less complications and better long-term treatment.