efficacy of laser lithotripsy treatment on a middle and distal ureteric calculus in Nakhon Phanom hospital

Abstract

The efficacy of laser lithotripsy treatment on a middle and distal ureteric calculus  in Nakhon Phanom hospital

Kitisriworaphan P.,  M.D., (Urologist), Nitidejvisit A.,M.Sc. (Biostatistics)

Nakhon Phanom Hospital,Thailand.

Abstract This study was the efficacy therapeutic research with historical controlled intervention design in patient undergoing uretero-renoscopelitholapaxy ;URSL at urological unit Nakhon Phanom Hospital.Objective: The study proposes were to demonstrate the clinical outcome of the efficacies and complications of the treatment of distal and middle ureteric stone with URSL Laser Lithotripsy (LL). Materials and methods :The target group was the patients were diagnosed with distal or middle ureteric stone and had the surgical condition with URSL Laser Lithotripsy (LL) and the data collection were taken from December,2024 to March, 2025, the patients were enrolled into study overall 60 cases. In addition the controlled group was the patients diagnosed with distal or middle ureteric stone and had to treatments with URSL Pneumatic Lithotripsy (PL). The data were taken by reviewing  retro-medical record in,2020 overall 60 cases. The tool of research was ureterorenoscopic technique auxillary with ureteric fragmentation Laser Lithotripsy (LL) and Pneumatic Lithotripsy (PL).The tool of data collection were the medical recode checklist and the data sheet of case record form. The perform of data analysis was frequency, percentage, mean, median, and SD. The inferential statistics were independent t-test, Chi-square, fisher’s exact probability test, and univariable and multivariable risk regression. The considered statistically significant was the p-value < 0.05.Results: The research outcome demonstrated that the URSL Laser Lithotripsy (LL) was improve the stone free rate up to 13.33 percent with statistically significant different at p-value 0.023.In addition when analyst with multivariable risk regression showed that the stone fragment time in URSL Laser Lithotripsy (LL) faster than URSL Pneumatic Lithotripsy (PL) 1.04 fold P-value 0.012 and the duration of stone free time in URSL Laser Lithotripsy (LL) upper to 94 percent with P-value <0.001. The complications such a stone retropulsion was higher in URSL Pneumatic Lithotripsy 60 percent than URSL Laser Lithotripsy P-value 0.026 and the Urosepsis criteria in post-operative 24-48 hour had found higher incident in the URSL Pneumatic Lithotripsy 2.0 fold at P-value <0.001.Conclusion: The Uretero-renoscopelitholapaxy with Laser Litho tripsy was high efficacy in treatment of a middle and distal ureteric calculus. The research was presented the clinical outcome with higher stone free rate and smaller the serious complications than the Pneumatic Lithotripsy.

Key word; Laser Lithotripsy, Pneumatic Lithotripsy, distal and middle ureteric stone, uretero-renoscopelitholapaxy ;URSL