背部小切口在经皮肾镜手术常规皮肾通道建立失败中的应用

Clinical application of dorsal mini-incision after failure of establishing percutaneous renal channel in percutancous nephrolithotomy

目的:探寻一种经皮肾镜手术常规皮肾通道建立失败时术中安全可行的非常规皮肾通道建立的方法。方法:在常规建立皮肾通道失败时,采用背部12肋下小切口,直视下建立皮肾通道作为补救措施。结果:6例手术均顺利清除肾及输尿管上端结石。自背部小切口开始至手术结束,历时40~80min,平均60min,避免了终止手术及二次手术可能引发的不良后果,同时避免了无法观察及不可预测的肾脏出血风险。结论:在常规经皮肾镜的微创不能完美拥有时,做出适度改变,在确保安全的前提下采用该术式,如期完成了预定手术。不失为安全有效的术式。

Objective:To explore and observe the clinical effect and safety of dorsal mini-incision with an unusual percutaneous renal channel after failure of building the conventional channel in percutaneous nephrolithotony.Methods:In the case of failure of establishing the conventional percutaneous renal channel.The mini-incision in the back rib 12 was used to establish the percutaneous renal channel under direct vision as a remedy.Results:In 6cases,stones of kidney and ureter were successfully removed.The operating time was 40-80min(60min on average).The dorsal mini-incision avoided the negtive effects of terminal and the second operation and the risk of inscrutable and unobservable renal hemorrhage.Conclusions:Great attention should be paid to dorsal mini-incision after failure of building the conventional percutaneous renal channel for urology specialists.