腹腔镜手术治疗鹿角形肾结石33例临床报告

Evaluation of Role of Peritoneoscopic Pyelolithotomy for Staghorn Calculi(Report of 33 Cases)

[目的]评价腹腔镜手术治疗鹿角形肾结石的临床效果。[方法]2006年3月至2011年2月行腹腔镜肾盂切开取石术(包括腹腔镜肾窦内肾盂取石术)治疗鹿角形肾结石33例(A组)以及开放手术肾盂切开取石术(包括肾窦内肾盂取石术)治疗鹿角形肾结石28例(B组),比较两组患者在年龄、手术时间、术中出血、术后住院天数以及结石清除率等指标。[结果]A、B两组在年龄、手术时间、结石清除率等方面比较差异无统计学意义(P>0.05);但A组在术中出血量、术后住院时间方面明显优于B组(P<0.01)。[结论]腹腔镜手术治疗鹿角形肾结石安全、可行,创伤小、出血少、恢复快,更能达到微创的效果。

[Objective]To evaluate the role of peritoneoscopic pyelolithotomy for the management of staghom calculi and its comparison with open surgery.[Methods]Between January 2006 and December 2010,we performed 33 laparoscopic pyelolithotomy(containing extended laparoscopic pyelolithotomy) and 28 open pyelolithotomy(containing extended pyelolithotomy) to treat the staghom calculi deseases.We evaluated the role of the laparoscopy in the management of staghom calculi in contrast to the open surgery by retrospectively analyzing the data of the age,total operation time, blood loss,time of postoperative hospital stay,and the clearance rate of the calculi.[Results]All the patients undergoing either peritoneoscopy(33 cases) or open surgery(28 cases) were successfully performed.Comparing the data of the laparoscopic surgery series(group A) and the open surgery series(group B),the mean age was(49.47±12.07)ages vs(45.86±12.83)ages;the mean operative time was(126.89±44.01)min vs(127.29±31.82) min,P>0.05;mean estimated blood loss was(108.89±96.44)ml vs(178.57±122.19)ml;mean time of postoperative hospital stay was(5.47±2.62)d vs (9.11±3.65)d;the stone clearance rate was 57.58-100%in group A and 61.34-100%in group B.[Conclusion]Our study shows that it is safe and feasibile for laparoscopic approach to treat the staghom calculi.This approach has the same efficiency as the traditional open approach to remove the stones,but more minimally invasive.We confirm that the laparoscopic approach can be chosen to manage those patients with staghom calculi in whom either the existing minimally invasive techniques have failed or an open operative procedure is being considered.