Management of renal caliceal diverticular calculi with minimally invasive percutaneous nephrolithotomy guided by B ultrasound（Report of seven cases）
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摘要: 目的：提高采用B超辅助定位微通道经皮肾镜取石术治疗肾盏憩室结石的技术水平。方法：2007年6月~2014年5月采用B超辅助定位微通道经皮肾镜取石术治疗肾盏憩室结石患者7例。结果：7例均Ⅰ期手术成功。手术时间平均62 min。术中出血量估计为10~80 ml。5例找到并行憩室管扩张，2例未能找到憩室管。5例结石主要成分均为草酸钙。术后3天内复查腹部平片，结石清除率100%。肾造瘘管在术后3~7天拔除，住院时间6~11天。4例术后3~12个月复查，2例憩室基本塌陷，2例憩室体积缩小超50%，憩室结石无复发。结论：采用B超辅助定位微通道经皮肾镜手术治疗肾盏憩室结石是安全、有效的微创治疗方法，建立经皮肾通道成功率高，出血少，创伤小，术后恢复快。Abstract: Objective: To elevate the level of treating renal caliceal diverticular calculi with minimally invasive percutaneous nephrolithotomy guided by B ultrasound.Method: From June 2007 to May 2014, seven patients diagnosed as renal caliceal diverticular calculi underwent minimally invasive percutaneous nephrolithotomy guided by B ultrasound.Result: All the patients were cured by one stage operation. The average operation time was 62 min, and the estimated blood loss was 10-80 ml during operation. The infundibulums were found and dilated in five cases and it can not be found in the other two patients. The main chemical composition of the stones were all calcium oxalate in five patients. Three days postoperatively, abdomenial X ray showed the stone free rate was 100%. The nephrostome was indwelled for 3-7 days and hospital stay was 6-11 days. Two caliceal diverticulars were found collapsed, and two caliceal diverticulars were found reduced more than half without stone recurrence over 3-12 months follow-up period.Conclusion: Management of renal caliceal diverticular calculi with minimally invasive percutaneous nephrolithotomy guided by B ultrasound is safe and effective. Percutaneous renal access may offer some advantages, including high success rate, little blood loss, little trauma and quick recovery.
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Key words:
- percutaneous nephrolithotomy /
- caliceal diverticular /
- renal calculi /
- ultrasound
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[1] Gross A J, Herrmann T R.Management of stones in calyceal diverticulum[J].Curr Opin Urol.2007, 17(2):136-140.
[2] 郝宗耀, 刘明, 梁朝朝, 等.B超引导下经皮肾镜钬激光碎石取石术治疗肾盏憩室10例报告[J].临床泌尿外科杂志, 2010, 25(10):759-760.
[3] Alwaal A, Azhar R A, Andonian S.Percutaneous holmium laser fulguration of calyceal diverticula[J].Case Rep Urol, 2012, 2012:716786.
[4] Auge B K, Maloney M E, Mathias B J, et al.Metabolic abnormalities associated with calyceal diverticular stones[J].Br J Urol, 2006, 97(5):1053-1056.
[5] Gross A J, Fisher M.Management of stones in patients with anomalously sited kidneys[J].Curr Opin Urol, 2006, 16(2):100-105.
[6] Wogan J M.Pyelocalyceal diverticulum:an unusual cause of acute renal colic[J].J Emerg Med, 2002, 23(1):19-21.
[7] Jones J A, Lingeman J E, Steidle C P.The roles ofextracorporeal shock wave lithotripsy and percutaneous nephrostolithotomyin the management of pyelocaliceal diverticula[J].J Urol, 1991, 146(3):724-727.
[8] Miller S D, Ng C S, Streem S B, et al.Laparoscopic management of caliceal diverticular calculi[J].J Urol, 2002, 167(3):1248-1252.
[9] Hoznek A, Herard A, Ogiez N, et al.Symptomatic caliceal diverticula treated with extraperitoneal laparoscopic marsupialization fulguration and gelatin resorcinol formaldehyde glue obliteration[J].J Urol, 1998, 160(2):352-355.
[10] Lobik L, Lopez-Pujals A, Leveillee R J, et al.Variables affecting deflection of a new third-generation flexible ureteropyeloscope(DUR-8 Elite)[J].J Endourol, 2003, 17(9):733-736.
[11] Kim S C, Kuo R L, Tinmouth W W, et al.Percutaneous nephrolithotomy for caliceal diverticular calculi:a novel single stage approach[J].J Urol, 2005, 173(4):1194-1198.
[12] Schwartz B F, Stoller M L.Percutaneous management of caliceal diverticula[J].Urol Clin North Am, 2000, 27(4):635-645.
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