肾窦内肾盂切开或加肾后下段联合切开治疗复杂性肾结石

Intrasinusal Pyelolithotomy or Incision of the Intrarenal Sinus Supplemented by a Postrenal Pole Segmental Incision for Complex Nephritic Stone

目的:探讨复杂性肾鹿角形结石的手术方法。方法:对采用肾窦内肾盂切开或肾窦内肾盂加肾后下段联合切开取石术的56例肾鹿角形结石患者的临床资料进行分析。结果:结石一次性取净50例,术后3个月B超或KUB+IVU检查见肾内残留结石7例,直径均小于1.0cm。56例患者均取石成功,手术平均时间110min,术中输血10例,平均输血量380 mL,取出结石最大9.5cm×7.5cm×5.6cm,结石最多1例达77枚。结论:肾窦内肾盂切开或加肾后下段联合切开取石术具有手术操作简单,取石干净,出血少,肾功能影响小等优点,是治疗肾内型肾盂鹿角形结石的良好术式。

Objective: To evaluate the surgical treatment of staghorn calculus and other complex calculus of kidney. Methods: The date of 56 cases treated with intrasinusal pyelolithotomy or an incision of the intrarenal sinus supplemented by a postrenal low pole segmental incision were analysed. Results: Single-time clearance was done in 50 cases. Postoperative examination with KUB+IVU or B ultrasound revealed residual stones in 7 cases, the diameters were all less than 1.0cm. Lithotomy was successful in all cases with the average operation time 110 minutes Blood transfusion during the procedure was required in 10 cases with an average of 380ml. The biggest stone was 9.5cm×7.5cm×5.6cm and in one case the number of stones was up to 77. Conclusion:The procedure didn′t need interruption of renal pedicle and with the advantages of simple, less bleeding, complete removal of calculus, and preservation of renal function. This method was suitable for intrarenal staghorn calculi.