微创经皮肾穿刺造瘘治疗马蹄肾结石

Minimally invasive percutaneous nephrostomy for treatment of calculi within horseshoe kidneys

目的 评价微创经皮肾镜治疗马蹄肾结石的安全性和有效性.方法 回顾性分析微创经皮肾镜取石术（PCNL）治疗马蹄肾患者的临床资料.结果 8例马蹄肾患者中3例为双肾结石.该组手术8例次采用12肋下穿刺,3例次经过11肋间穿刺;9例次为单通道取石,2例次为2个通道取石,其中经上盏穿刺5例次,经中盏穿刺4例次,上盏＋中盏穿刺2例次.73%（8/11）的患者可通过一次手术清除结石,平均手术时间150min,平均住院天数10 d.该组病例中没有重大并发症出现.随访3～21个月,未见有结石复发.结论 微创经皮肾镜穿刺取石术治疗马蹄肾结石是一种安全有效的方法.

[Objective] To assess the safety and feasibility of minimally invasive percutaneous nephrolithotomy （mPCNL） in treating calculi within horseshoe kidney. [Methods] We retrospectively investigated the outcome of 8 patient of calculi within horseshoe kidneys who were treated with minimally invasive percutaneous nephroli-thomy. [Results] Of 8 cases,calculi within bilaterall horseshoe kidneys was 3. Access to the horseshoe kidneys was subcostal in 8 and supracostal in 3, A single tract was used in 9 kindeys, and two tracts were created in the remaining 2, renal access was obtained through upper calyx in 5 cases, a middle calyx in 4, and upper＋middle calices in 2 cases. 73% （8/11） were rendered stone free at 1 session. Average operation time was 150 munites, and the mean hospital stay was 10 days. No major complications were seen. Follow up was 3 to 21 months, no stone recurrence was noted. [Conclusions] Minimal-ly invasive percutaneous nephrolithotomy is a safe and effective method of stone re-moval in patients with calculi in horseshoe kidneys.