肾窦内肾盂加肾后唇切开术治疗鹿角状肾结石

Intrasinus Pyelotomy and Excision of Retro-labium for Stag-horn Calculus

目的探讨肾窦内肾盂加肾后唇切开术治疗鹿角状肾结石的疗效. 方法鹿角状肾结石患者40例,单侧36侧,双侧4侧,肾盂均为肾内型,肾实质无明显萎缩,肾功能均正常,均施行肾窦内肾盂加肾后唇中下段无血管区切开取石术. 结果本组均在常温下手术,未阻断肾蒂,结石均安全取出,无术中严重并发症发生.平均手术时间115(90～140)min,平均失血量为100(90～120)ml,术后1月拔除双J管,复查3例(7.5%)有肾盂内小结石残留. 结论肾窦内肾盂加肾后唇中下段区切开取石术适合肾鹿角状结石的治疗,具有操作较简单、易掌握,取石容易且结石一次性取出率高,出血少的优点.

Objective To assess the therapeatic effect of intrasinus pyelotomy and excision of retro-labium for stag-horn calculus. Method 40 cases of stag-horn calculus, inclucling unilateral in 36 cases and bilateral in 4 cases, underwent intrasinus pyelotomy and excision of retro-labium. All cases had normal renal function and no renal atrophy was found. Result Calculus was removed in all cases without renal pedicle blockade under room temperature. Average operative time was 115(90～140)min, average blood loss was 100(90～120)ml. Double “J” tube was removed 1 month postoperatively. 3 cases of residual calculus were found in renal sinus. Conclusion Intrasinus pyelotomy and excision of retro-labium is an optimal opproach for stag-horn calculus with simple manual, high success rate and minimal blood loss.