细径经皮肾镜治疗复杂性肾结石65例报告

Treatment of the Complex Renal Calculi with Mini-Percutaneous Nephrolithotomy(A Report of 65 cases)

目的探讨微创治疗复杂性肾结石的效果。方法采用18.5F细径经皮肾镜、气压弹道碎石机,对各种复杂性肾结石65例实施细径经皮肾镜碎石、取石术。结果Ⅰ期碎石取石术60例,Ⅱ期5例。1次手术取尽41例,2次取尽20例,结石清除率93.4%,并用体外冲击波碎石4例,手术时间(75±21)min。扩张皮肾通道时无明显出血,无损伤周围脏器,无导致肾切除的病例。结论采用细径经皮肾镜治疗复杂性肾脏结石是安全、有效的微创术式。

Objective To investigate the treatment of the complex renal calculi with minimally invasive endoscopic surgery. Methods From Dec 2003 to Jan 2006, 65 cases with the complex renal stone were treated with pneumatic lithotripsy under 18.5F mini-percutaneous nephroscope. Results 60 cases were underwent one-stage invasive percutaneous nephrolithotomy（PCNL）, and 5 cases were performed at twice. 41 cases presented stone-free on the first PCNL and 20 were underwent the second management because of residual stone （the rate of stone clearance was 93.4 %）. 4 patients required extracorporeal shock wave lithotripsy（ESWL） after managed by second PCNL. The operation time was 75±21 min. No severe complications, such as hemorrhage, abdominal organs injury or loss of the kidney, were occurred. Conclusion Mini-percutaneous nephrolithotomy is a safe, effective and minimally invasive for managing the complex renal stone.