微创经皮肾取石术治疗肾铸形结石

Treatment of Staghorn Renal Calculi with Minimally Invasive Percutaneous Nephrolithotomy

目的:研究微创经皮肾输尿管镜治疗肾较大铸形结石的可行性及解决一些临床具体问题。方法:收集本院自2003年1月至2005年11月住院较大的肾铸形结石病人112例。通过C臂X光机及微小切口辅助建立安全、准确肾瘘通道进行碎石;采用输尿管气囊管防止结石残留至输尿管下段。结果:手术Ⅰ期完成104例,占92%;术中出血需输血12例,占10%;术后残存结石21例,占19%;无1例误穿。结论:微创经皮肾取石术(minimally invasive percutaneous nephrolithotomy,MPCNL)可成为治疗肾铸形结石的有效手段。

Objective： To investigate the feasibility and clinical use of minimally invasive percutaneous nephrolithotomy （MPCNL） in staghorn renal calculi. Methods： One hundred and twelve patients with large staghorn renal calculi included in this study were registered to our hospital between January 2003 and November 2005. The calculi were fragmented via proper percutaneous tracts established through small incisions and under C-arm fluoroscopy guidance. At the end of procedure, a balloon ureteral stent was placed for each patient to prevent formation of residual stones at the distal ureter. Results ： One hundred and fourteen cases （92%） were treated with one session. Blood transfusion was necessary in 12 patients （10%）. Postoperative evaluation showed residual calculi in 21 patients （19%）. Inadvertent tissue injury by puncture was found in none of the cases. Conclusion： MPCNL may be an effective modality for treatment of staghorn renal calculi.