本文研究順行輸尿管腎臟鏡手術於上段輸尿管結石所佔的角色及其成功機率。取材自最近三十二個月[1995,1月至1997,7月]因上段輸尿管結石而接受順行輸尿管腎臟鏡手術的病例。手術進行方法分為由泌尿科醫師或放射科醫師進行造口二種方法。結果有十四例於一次單一手術清除結石，有二例需要輸尿管鏡把石頭推回腎臟，另一例雖然有輸尿管鏡幫忙，還是失敗，最後迷行輸尿管截石術。成功率為百分之九十三點五。結論為順行輸尿管腎臟鏡手術於上段輸尿管結石的處理有高的成功率，尤其是無法進行體外膿波或是失敗病例，以及逆行輸尿管腎臟鏡碎石術失敗的病例適用，可避免不必要的截石術。

The purpose of this study was to evaluate the role and success rate of antegrade uret-erorenoscopic manipulation on upper ureteral stones. For this study, several conditions of upper ureteral stones, with a total of 17 stones, were chosen within the most recent 32 mon. Patients included those whose bodies were inappropriate to accept extracorporeal shock wave lithotripsy (ESWL),for example, those with coupling failure; patients who had been accepted for ESWL or ureterorenoscopic lithotripsy (URSL), but whose treatment failed: patients whose upper ureteral stones were too large to undergo ESWL or URSL; and also patients who were chosen by surgeons to accept antegrade ureterorenoscopic manipu-lation. Fourteen upper ureteral stones accepted the antegrade ureterorenoscopic manipulation. Access was created in the operating room by urologists. The stones were also extracted at the same time. Three upper ureteral stones accepted antegrade ureterorenoscopic manipulation, when access was created by radiologists. The next morning the stones were extracted in the op-erating room by the urologists. The obstructing stones in each of the 14 cases of upper ureteral stones were removed in a single procedure. Two other cases of upper ureteral stones following URS push back had suc-cessful antegrade ureteroreenoscopic manipulation. One upper ureteral stone failed to accept the antegrade ureterorenoscopic manipulation and the ureterorenoscopy (URS) push back. Fi-nally this patient accepted ureterolithotomy. In general, The success rate was 93.5%. Antegrade ureterorenoscopic manipulation of upper ureteral stones is safe and effective with a high success rate. This procedure can be selected for patients who have upper ureteral stones failing to accept ESWL or URSL. Using this procedure can avoid more invasive proce-dures, such as lithotomy. (J Urol R.O.C., 9:126-131,1998)