【摘要】 目的:利用改良Satava classification system评估新疆维吾尔自治区医院及江西新余地区医院经输尿管镜处理输尿管结石的经验及并发症。方法:回顾性分析1 563例经输尿管镜处理输尿管结石的患者(男877例,女686例),根据改良Satava classification system评估手术并发症分为1~3级,1级为有并发症但不需处理没有任何不良后果的,2级为并发症需要经内镜在术中处理(2a)或术后内镜处理的(2b),3级为并发症需要开放或腹腔镜处理的。结果:经输尿管镜碎石取石术后完全取出或结石碎片自行排出的1 348例(86.2%)。手术并发症总发生率为216例(13.8%),其中输尿管上段结石移位进入肾盂为4.6%,黏膜损伤3.8%,出血2.3%,输尿管镜不能进入到达结石部位2.1%,黏膜下假道3.15%,输尿管穿孔1.15%,输尿管撕裂伤脱套0.13%。根据改良Satava classification system评估:1级的为4.9%,2级a为4.6%,b为3.74%,3级为0.56%。结论:改良Satava classification system对于经输尿管镜处理输尿管结石出现的并发症严重程度有较好的描述作用,可指导正确的临床处理和评估并发症的预后,同时也可以用来与其他文献比较而更好的服务于临床工作。更多还原

【Abstract】 Objective:To review intraoperative complications following ureteroscopy lithotripsy(URL)according to our experience with URL in the treatment of ureteral stones and stratify intraoperative complications following URL according to the modified Satava classification system.Methods:The clinical data of 1 563patients(877males and 686females)were retrospectively.Intraoperative complications were recorded according to modified Satava classification system.Grade 1complications included incidents without consequences for the patients;grade 2complications,which are treated intraoperatively with endoscopic surgery(grade 2a)or required endoscopic re-treatment(grade 2b);and grade 3complications included incidents requiring open or laparoscopic surgery.Results:The stones were completely removed in 1 348(86.3%).The overall incidence of intraoperative complications was 13.8%.The most common complications were proximal stone migration(4.6%),mucosal injury(3.8%),bleeding(2.3%),inability to reach stone(2.1%),ureteral perforation(1.15%)and ureteral avulsion(0.13%),mucosal tears or false-route(3.15%).According to modified Satava classification system,grade 1accounted for 4.9%,grade 2afor4.6%,grade 2bfor 3.74%,and grade 3for 0.56% respectively.Conclusions:Modified Satava classification is a quick and simple system for using to describ the severity of intraoperative URL complications and this grading system will help to compare for the available surgical outcomes from different centers.更多还原