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Outcomes of Flexible Ureteroscopic Lithotripsy with Holmium Laser for Upper Urinary Tract Calculi

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Outcomes of Flexible Ureteroscopic Lithotripsy with Holmium Laser for Upper Urinary Tract Calculi Clinical Urology Outcomes of Flexible Ureteroscopic Lithotripsy International Braz J Urol Vol. 34 (2): 143-150, March - April, 2008 Outcomes of Flexible Ureteroscopic Lithotripsy with Holmium Laser for Upper Urinary Tract Calculi Marcello Cocuzza, Jose R. Colombo Jr, Antonio L. Cocuzza, Frederico Mascarenhas, Fabio Vicentini, Eduardo Mazzucchi, Miguel Srougi Division of Urology, University of Sao Paulo, USP and Department of Urology, Syrian-Lebanese Hospital, Sao Paulo, Brazil ABSTRACT Objective:7RDVVHVVWKHSHULRSHUDWLYHDQG¿QDQFLDORXWFRPHVRIÀH[LEOHXUHWHURVFRSLFOLWKRWULSV\ZLWKKROPLXPODVHUIRU XSSHUWUDFWFDOFXOLLQSDWLHQWV Materials and Methods:%HWZHHQ)HEUXDU\DQG6HSWHPEHUSDWLHQWVWUHDWHGIRUXSSHUWUDFWVWRQHZLWKÀH[- LEOHXUHWHURVFRSLFOLWKRWULSV\ZHUHHYDOXDWHG5HQDOVWRQHVZHUHDVVRFLDWHGZLWKFROOHFWLQJV\VWHPREVWUXFWLRQLQ SDWLHQWVIDLOHGH[WUDFRUSRUHDOVKRFNZDYHOLWKRWULSV\ 6:/ RFFXUUHGLQ SDWLHQWVXQLODWHUDOPXOWLSOHVWRQHVLQ SDWLHQWVDQGPXOWLSOHELODWHUDOVWRQHVLQ ,Q SDWLHQWVWKHVWRQHZDVORFDWHGLQWKHLQIHULRUFDO\[ 3HULRSHUDWLYHDQG¿QDQFLDORXWFRPHVZHUHDOVRHYDOXDWHG Results: SURFHGXUHVZHUHSHUIRUPHGLQSDWLHQWV7KHPHDQVWRQHEXUGHQRQSUHRSHUDWLYH&7VFDQZDVr PP7KHPHDQRSHUDWLYHWLPHZDVrPLQ7KHVWRQHIUHHUDWHZDVDIWHURQHSURFHGXUHDQGDIWHUD VHFRQGSURFHGXUHZLWKRYHUDOOFRPSOLFDWLRQUDWHRI7KHUDSHXWLFVXFFHVVRFFXUUHGLQDQGRISDWLHQWVZLWK ORZHUSROHVWRQHVDQG6:/IDLOXUHUHVSHFWLYHO\7UHDWPHQWIDLOXUHRIDVLQJOHVHVVLRQZDVDVVRFLDWHGZLWKSUHVHQFHRID VWRQHVL]HODUJHUWKDQPP(S EXWQRWDVVRFLDWHGZLWKLQIHULRUFDO\[ORFDWLRQ S 6XUJLFDOGLVSRVDEOHV ZHUHUHVSRQVLEOHIRURIRYHUDOOFRVWV Conclusion:)OH[LEOHXUHWHURVFRS\XVLQJKROPLXPODVHULVDVDIHDQGHIIHFWLYHRSWLRQIRUWKHWUHDWPHQWRIXSSHUXULQDU\ WUDFWFDOFXOL,QDGGLWLRQLWFDQEHFRQVLGHUHGDQDWWUDFWLYHRSWLRQDVVDOYDJHWKHUDS\DIWHU6:/IDLOXUHRUNLGQH\FDOFXOL DVVRFLDWHGZLWKXUHWHUDOVWRQHV6WRQHVL]HODUJHUWKDQPPLVDVVRFLDWHGZLWKVLQJOHVHVVLRQWUHDWPHQWIDLOXUH Key words: ureter; calculi; Lithotripsy; Holmium laser Int Braz J Urol. 2008; 34: 143-50 INTRODUCTION WRPHWKRGVZLWKPRUHHIIHFWLYHWKHUDSHXWLFRSWLRQV DQGORZHUPRUELGLW\6:/KDVUHYROXWLRQL]HGWKH 8UHWHURVFRS\KDVHYROYHGDVWKHPRVW WUHDWPHQWRIXSSHUWUDFWVWRQHVDQGKDVEHFRPHWKH PLQLPDOO\LQYDVLYHDSSURDFKWRWKHXUHWHUDQGNLGQH\ PRVWHPSOR\HGRSWLRQIRUWKHVHW\SHVRIVWRQHVDV VLQFHLWZDV¿UVWXVHGLQE\+DPSWRQZKRDF- ZHOO +RZHYHULWVVXFFHVVUDWHVDUHIDUIURPVDW- FLGHQWDOO\HQWHUHGDPDVVLYHGLODWHGXUHWHUZLWKD) LVIDFWRU\DQGPD\YDU\IURPIRUWKRVHVPDOOHU F\VWRVFRSH 7KHPDQDJHPHQWRIXSSHUWUDFWVWRQH WKDQFPWRIRUVWRQHVJUHDWHUWKDQFP GLVHDVHKDVVKLIWHGIURPWKHLQYDVLYHQHSKUROLWKRWRP\ 3HUFXWDQHRXVQHSKURVWROLWKRWRP\ 3&1/ KDVPDGH 143 Outcomes of Flexible Ureteroscopic Lithotripsy LWSRVVLEOHWRDFKLHYHDVWRQHIUHHUDWHRIPRUHWKDQ Table 1 –'HPRJUDSKLFVRISDWLHQWVWUHDWHGZLWKÀH[LEOH ZLWKLQKHUHQWULVNVRIWKHSHUFXWDQHRXVDFFHVV ureteroscopy lithotripsy with holmium laser for upper tract 5HFRJQLWLRQRIWKHOLPLWDWLRQVRI6:/DQG3&1/ calculi. 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