Flexible ureteroscopic holmium laser lithotripsy with PolyScope for senile patients with renal calculi

摘要

The present study reported the clinical experience of using a PolyScope with holmium laser lithotripter in managing renal calculi in senile patients. Between December 2013 and December 2016, 157 senile patients (69.1 +/- 6.1 years old) were treated with PolyScope holmium laser lithotripsy for renal calculi at Xin Hua Hospital (Shanghai, China). The mean stone digitized surface area was 154.2 +/- 57.7 mm(2) (range, 55.8-478.3 mm(2)). A thorough medical history investigation, and laboratory and radiological examination were followed by proper preoperative management. The PolyScope was then passed into the renal cavities following the position of the ureteral access sheath, with laser energy maintained at 1.0-2.0 J, frequency 10-15 Hz. The demographical and operative information of senile patients were compared with that of the 332 non-senile patients operated at the same period time. The average operative time was 54.6 +/- 13.2 min (range, 37-124 min). No major complications, including ureteral perforation or sepsis were encountered. The single session stone-free rate (SFR) was 81.5% and the overall SFR was 89.2%, similar to that of the non-senile group. PolyScope combined with holmium laser lithotripter is safe and effective in managing renal calculi in senile patients compared with non-senile patients, with considerately high SFRs and low complication rates.