Tratamento transureteroscópico do cálculo ureteral com HOLMIUM: YAG laser / Transureteroscopic treatment of ureteral stones with the Holmium:YAG laser

AUTOR(ES)
DATA DE PUBLICAÇÃO

2004

RESUMO

Objetive: Holmium:YAG laser is the more recently method of intracorporeal lithotripsy of urinary calculi introduced in our area. The purpose of this study is to analyze the technique and to evaluate the immediate results and complications in the treatment of patients with ureteral calculi. Casuistry and Methods: Sixteen patients were treated, nine men and seven women, carrying symptomatic ureteral stones, bigger than 6 mm or with evolution superior to 30 days. The average age was 42 years old (6-88 years old). Four stones were localized in upper ureter, six in middle ureter, and six in lower ureter. The technique employed was the vaporization of the stone with Holmium:YAG laser, through ureteroscopy. It was used exclusively 7-Fr semirigid ureteroscope. Results: The rate of success attained was of 87.5%, with no statistically significant differences regarding the reports in literature. All the stones were fragmented. The two failures of the series occurred with stones localized in upper ureter, in which fragments were displaced to kidney. The complications observed were three ureteral perforations and two fever cases. Conclusion: Holmium:YAG laser is effective in the endoscopic treatment of ureteral stones. Measures aimed at preventing retrograde migration of stones or fragments should be taken, mainly when the stone are located in the upper ureter. However, lithotripsy with Holmium:YAG laser may be associated with complications, particularly in what concerns the treatment of impacted stones.

ASSUNTO(S)

litrotipsia a laser/efeitos adversos resultado de tratamento ureteroscopia/métodos lasers/uso terapêutico lasers/therapeutic use lithotripsy laser/adverse effects cálculos ureterais/cirurgia ureteral calculi/surgery ureteroscopy/methods treatment outcome

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