肾盂切开联合内腔镜治疗孤立肾鹿角型结石的疗效观察

刘边疆; 张杰秀; 李鹏超; 韩志坚; 鲁佩; 李杰; 张炜; 王增军; 殷长军

doi:10.13201/j.issn.1001-1420.2014.02.002

肾盂切开联合内腔镜治疗孤立肾鹿角型结石的疗效观察

- 南京医科大学第一附属医院泌尿外科(南京, 210029)
基金项目:
国家自然科学基金青年科学基金项目(编号81200467)

江苏高校优势学科建设工程资助项目(编号JX10231801)

详细信息

通讯作者: 李杰, E-mail:drj_li@163.com

中图分类号: R699

收稿日期: 2013-11-26

Pyelolithotomy combined with endoscope for staghorn stones in solitary kidney

- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China

More Information

Corresponding author: LI Jie, E-mail: drj_li@163.com

Received Date: 26 November 2013

摘要

摘要: 目的: 探讨肾盂切开联合内腔镜治疗孤立肾鹿角型结石的治疗效果和操作应用体会。方法: 4例孤立肾鹿角型结石患者首先接受肾盂切开取石术。术中沿肾盂切口置入膀胱镜或输尿管镜,在内腔镜监视下进行钬激光碎石取石术,直至肾盂和肾盏内结石完全清除。总结分析相关临床资料。结果: 手术均顺利完成。平均手术时间120 min。术中术后无出血、感染等并发症。术后平均住院时间5 d,结石清除率100%。随访12个月无肾积水、肾盂狭窄或结石复发。结论: 肾盂切开联合内腔镜治疗孤立肾鹿角型结石技术和设备要求少,安全高效。
- 肾盂切开取石 /
- 膀胱镜 /
- 输尿管镜 /
- 孤立肾 /
- 鹿角结石
Abstract: Objective: To evaluate efficiency and feasibility of pyelolithotomy combined with endoscope for staghorn stones in solitary kidney. Method:Four patients with staghorn stones in solitary kidney were recruited. Pyelolithotomy was performed to expose and remove pelvic stones. Cystoscope or ureteroscope was inserted into pelvis and every calices along the pelvic incision and lithotripsy was continued using holmium laser. Result:All operations were performed successfully. Average operation time was 120 min. No complications were observed. Average postoperative hospital stay was 5 d. Stone clearance rate was 100%. No hydronephrosis, narrow pelvis or stone recurrence occurred during 12-month follow-up. Conclusion: Pyelolithotomy combined with endoscope is safe and effective for staghorn stones in solitary kidney.Key words pyelolithotomy; cystoscope; ureteroscope; solitary kidney; staghorn stone
- pyelolithotomy /
- cystoscope /
- ureteroscope /
- solitary kidney /
- staghorn stone

HTML全文

参考文献(13)

[1]	那彦群, 叶章群, 孙光主编.中国泌尿外科疾病诊断治疗指南手册 (2011版)[M].北京:人民卫生出版社, 2011:265-276.
[2]	Antonelli J A, Pearle M S.Advances in percutaneous nephrolithotomy[J].Urol Clin North Am, 2013, 40 (1):99-113.
[3]	李声宏, 邢念增.经皮肾镜碎石术并发症及其预防[J].临床泌尿外科杂志, 2012, 27 (2):156-158.
[4]	Mitropoulos D, Artibani W, Graefen M, et al.Reporting and grading of complications after urologic surgical procedures:an ad hoc EAU guidelines panel assessment and recommendations[J].Eur Urol, 2012, 61 (2):341-349.
[5]	El-Nahas A R, Shokeir A A, El-Assmy A M, et al.Colonic perforation during percutaneous nephrolithotomy:study of risk factors[J].Urology, 2006, 67 (5):937-941..
[6]	Gonen M, Turan H, Ozturk B, et al.Factors affecting fever following percutaneous nephrolithotomy:aprospective clinical study[J].J Endourol, 2008, 22 (9):2135-2138.
[7]	Skolarikos A, de la Rosette J.Prevention and treatment of complications following percutaneous nephrolithotomy[J].Curr Opin Urol, 2008, 18 (2):229-234.
[8]	Desai M, De Lisa A, Turna B, et al.The clinical research office of the endourological society percutaneous nephrolithotomy global study:staghorn versus nonstaghorn stones[J].J Endourol, 2011, 25 (8):1263-1268.
[9]	何永忠, 刘建河, 曾国华, 等.微创经皮肾镜取石术后迟发出血原因及介入治疗[J].中华泌尿外科杂志, 2006, 27 (6):371-373.
[10]	周祥福, 高新, 温机灵, 等.平卧位微穿刺造屡经皮肾镜碎石取石术56例报告[J].中华泌尿外科杂志, 2006, 27 (11):728-730.
[11]	Yamaguchi A, Skolarikos A, Buchholz N P, et al.Operating times and bleeding complications in percutaneous nephrolithotomy:a comparison of tract dilation methods in 5537patients in the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study[J].J Endourol, 2011, 25 (6):933-939.
[12]	de la Rosette J, Assimos D, Desai M, et al.The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study:indications, complications, and outcomes in 5803patients[J].J Endourol, 2011, 25 (1):11-17.
[13]	Bucuras V, Gopalakrishnam G, Wolf J S Jr, et al.The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study:nephrolithotomy in 189patients with solitary kidneys[J].J Endourol, 2012, 26 (4):336-341.