输尿管镜联合微创经皮肾镜取石术治疗重度输尿管石街

Treatment of the severe ureteral steinstrasse with ureteroscopic lithotripsy and minimally invasive percutaneous nephrolithotomy

目的总结输尿管镜取石联合微创经皮肾镜取石术(mPCNL)治疗重度输尿管石街的经验。方法对18例重度输尿管石街(平均长径达8.3 cm)患者采用输尿管镜下气压弹道碎石取石,并将结石上推到肾盂后再行微创经皮肾镜取石术。结果所有患者均一次取净输尿管内结石,并且无输尿管穿孔、输尿管狭窄及大出血等严重并发症。结论输尿管镜取石(URL)联合微创经皮肾镜取石术(mPCNL)治疗重度输尿管石街,不仅缩短手术时间,降低输尿管损伤的机会,也可同时处理肾结石,是一种理想手术方式。

Objective To sum up the experiences in the treatment of serious ureteral steinstrasse with ureteroscopic lithotripsy （URL） and minimally invasive percutaneous neprolithotomy （mini-PCNL） . Methods 18 patients of serious ureteral steinstrasse （average 8.3 cm） were mangedby mini-PCNL after the stone were pushed back to the renal pelvic under the ureteroscopy and pneumatic lithotripy. Results All cases were stone-free with one procedure, and no cmplications such ureter perforation, avulsion, severe bleeding happened. Conclusion Using URL and mini-PCNL to manage serious ureteral steinstrasse can drastically shorten the operative time and lessen morbidity, and undoubtedly this is a excellent modality.