多通道微创经皮肾输尿管镜取石术治疗肾鹿角型结石

Treatment of kidney Staghorn stones with minimally invasive percutaneous nephrolithotomy

目的:探讨F14～F16多通道微创经皮肾输尿管镜取石术治疗肾鹿角型结石的安全性与有效性.方法:利用微创多通道经皮肾输尿管镜取石术治疗肾鹿角型结石108例.结果:108例患者中,合并肾积脓16例,先行经皮肾穿刺造瘘术,5～7 d后行二期经皮肾镜取石术,其余92例患者均行一期取石,所有患者均为1～3通道取石,结石清除率86%.1例孤肾肾结石合并积脓,行一期取石,术后出现中毒性休克,1例合并糖尿病患者术后出现酮症酸中毒,其余未出现大的并发症.结论:微创多通道经皮肾输尿管镜取石术治疗肾鹿角型结石安全、效果好、创伤小、恢复快.

Objective To assess the safety and feasibility of minimally invasive percutaneous nephrolithotomy in treating kidney Staghorn stones. Methods One hundred and eight patients with kidney calculi treated by minimally invasive percutaneous nephrolithotomy from January 1998 to May 2004 were retrospectively investigated.Results Of 108 cases, 86% stone-free rate was achieved using one-stage minimally invasive percutaneous nephrolithotomy. All cases were with 1 to 3 tracts. Only one case of pyonephrosis suffered from postoperative infective shock in one-stage minimally invasive percutaneous nephrolithotomy. Another one case of diabetes suffered from postoperative ketoacidosis, no major complications were noted in the other patients. Conclusion Minimally invasive percutaneous nephrolithotomy is safe and effective in treating kidney calculi. Compared to traditional percutaneous nephrolithotomy, it has the advantages of less invasion and easy recovery.