ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG CỦA CÁC BỆNH NHÂN ĐƯỢC NỘI SOI TÁN SỎI THẬN – NIỆU QUẢN 1/3 TRÊN QUA ỐNG SOI MỀM SỬ DỤNG NĂNG LƯỢNG HOLMIUM LASER TẠI BỆNH VIỆN 19-8

Abstract

Objective: To study the clinical and subclinical characteristics of patients undergoing flexible ureterorenoscopy with Holmium laser lithotripsy for upper ureteral and kidney stones at Hospital 19-8. Subjects and methods: Patients diagnosed with kidney stones and/or ureteral stones treated with retrograde intrarenal surgery using a flexible scope at Hospital 19-8 from January 2025 to June 2025. Results: Through a study of 32 patients; General characteristics of the study sample: The average age was 52.02 ± 11.15 years, with the 40-60 age group accounting for the majority (60.2%). The male/female patient ratio was approximately 2.25/1. The majority of patients (75%) had no history of ipsilateral urinary stone intervention. The most common reasons for admission were dull flank pain (28.1%), followed by renal colic (21.9%) and accidental detection (21.9%). Subclinical characteristics; Blood tests: 100% of patients had Urea within the normal range and 78.1% had normal Creatinine. 37.5% of patients had an elevated white blood cell (WBC) count (>10 G/L). Preoperative urine culture test: There were 5 cases with positive urine cultures; the isolated bacteria was E. coli in all cases. Diagnostic imaging: Grade II hydronephrosis accounted for the highest rate (46.9%), followed by Grade I (40.6%). There were no cases of Grade III or IV hydronephrosis. Regarding location, stones in multiple locations were the majority (56.2%), and upper ureteral stones accounted for 21.9%. Regarding size, the 10-20mm stone group had the highest rate (68.8%). Regarding the anatomical characteristics of the pelvicalyceal system, 78.1% of patients had a lower calyx length ≤ 30mm and 100% had a lower calyx infundibular width > 5mm. Conclusion: A thorough preoperative clinical assessment is one of the important steps. This includes: (1) assessing the size and location of the stone: Large stones (>2cm) or those in complex locations may require multiple lithotripsy sessions or combination with other methods, (2) the anatomical status of the urinary tract: Anatomical abnormalities such as ureteral stricture, infundibular stenosis, or posterior urethral valves can all affect the lithotripsy results, (3) Infection status: urinary tract infections need to be stabilized before surgery to avoid complications.