Abstract: [ Abstract ] Objective To evaluatethe safety and clinical value of modularflexible
ureteroscopecombinedwithholmiumlaserforthetreatmentofupperurinarycalculi.Methods
Threehundredandfifty-eightpatientswithupperurinarycalculiweretreatedbymodularflexible
ureteroscopecombinedwithholmiumlaser , including125casesofupperureteralcalculiwitha
meandiameterofrange13-23mm , average ( 17. 3±1.3 ) mm , 105casesofrenalpelviscalculi ,
63casesofcalculiinupperandmiddlecalyxand65casesoflowercalyxcalculi.Twohundredand
thirty-threecases with diameterrange 14- 39mm were classifiedinto patients with the
diameter<20mm ( n =146 ), withameandiameterofrange14-19 mm , average ( 16. 5±1.4 )
mm , andpatientswiththediameter≥20 mm ( n =87 ), ameandiameterofrange20-39mm ,
average ( 24. 3±6.5 ) mm.Demographicdata , operativeduration , complicationrate , andstone-
freeratewererecorded.Results Lithotripsywasperformedsuccessfullyinpatientswiththe
upperureteralcalculiandthosewithrenalcalculi.Stoneclearancerateinupperureteralcalculi
groupwerehigherthanthatinrenalcalculigroup , butwithshorteroperatingtime.Andstone
clearancerateinthecaseswiththestonesdiameter<20mm werehigherthanthatinthecases withthestonesdiameter≥20 mm.Accordingtothepositionofthestone , there wasno
significantdifferenceintherateofsuccessrate , thetimeofoperation , thesuccessrateandthe
operationtimeofthesubgroupsofdifferentpartsofthekidneystones.Therewerenosevere
complications , exceptClaviengrade Ⅰ or Ⅱ.Tenpatientshadpostoperativehighfeverand
chills.Threepatientswhohadshocksymptomssuchashypotensionwerecuredbyanti-infective
andanti-shocktherapy.Therewasnosignificantdifferencebetweenthetwogroups.Conclusion
Modularflexibleureteroscopecombinedwithholmiumlaserisanestablishedminimalinvasive
treatmentfortheupperurinarycalculiwithahighsuccessrateandlow morbidity.Modular
flexibleureteroscopewithholmiumlasercanbethefirstchoiceforthetreatmentofupperurinary
calculi.

Key words: upper urinary calculi, modular flexible ureteroscope, holmium laser