MPCNL联合输尿管镜治疗肾结石并输尿管结石体会(附52例报告)

Concomitant Minimally Invasive Percutaneous Nephrolithotomy and Transurethral Ureterorenoscopic Pneumatic Lithotripsy for Ureteral Calculi Complicated by Renal Calculi (Report of 52 cases)

目的:评价MPCNL联合输尿管镜治疗肾结石合并输尿管结石的安全性、有效性及优越性。方法我院于2010年10月~2013年10月采用 MPCNL联合输尿管镜治疗52例肾结石合并输尿管结石。其中同侧输尿管结石19例,异侧输尿管结石33例。输尿管中段结石18例,下段结石34例。结果本组52例中41例一期成功碎石,5例二期成功碎石,6例残石尊重患者意见随访或日后行ESWL治疗。无严重并发症发生。手术时间:50~140min,平均80min。术后5~7d复查B超及腹部平片,5例二期手术清除残留结石。结石完全清除46例(88.46%)。术后住院时间6~10d,平均8d。结论 MPCNL联合输尿管镜治疗肾结石合并输尿管结石是安全的、高效的,同时具有一次性解决输尿管结石和肾结石的优越性。

Objective To summarize our experience on concomitant minimal y invasive percutaneous nephrolithotomy and Transurethral ureterorenoscopic pneumatic lithotripsy for ureteral calculi complicated by renal calculi,and to assess its safety and feasibility.Methods Total y 52 patients with ureteral calculi complicated by renal calculi received operations in our urologic center during October,2010 to October 2013.Among the 52 patients,19 patients suf ered ipsilateral ureteral calculi complicated by renal calculi and the other patients with contralateral ureteral calculi complicated by renal calculi.Results The procedures succeed in 52 patients without serious complications,41 patients could be treated by Concomitant percutaneous nephrolithotomy and Transurethral ureterorenoscopic pneumatic lithotripsy at the stage one,5 patients received stage two operations and 6 patients received ESWL after stage one operations.The operative duration was 50~140 minutes,mean 80 minutes.The KUB and ultrasound examinations were performed five to seven days after operations.The stone-free rate on discharge was 88.46%(46/52).The patients were discharged on the 6th to 10th postoperative day(mean 8th).Conclusion Concomitant minimal y invasive percutaneous nephrolithotomy and Transurethral ureterorenoscopic pneumatic lithotripsy is a safe and ef ective alternative for ureteral calculi complicated by renal calculi.