腹腔镜技术治疗肾盏憩室结石(附12例报告)

Application of laparoscopic techniques in the treatment of the calceal diverticular cal- culi(Report of 12 cases)

目的探讨腹腔镜技术治疗肾盏憩室结石的手术方法和疗效。方法本组12例肾盏憩室合并结石患者,男7例、女5例,平均年龄37.3岁,平均病程3.6年。临床表现为腰痛、反复泌尿系感染、肉眼血尿,均经CT或静脉尿路造影(IVU)证实为肾盏憩室结石诊断。全麻下行腹腔镜肾盏憩室切除术、肾楔形切除术或肾部分切除术等。结果12例手术均获得成功,手术时间为83～170 min,平均105 min,术中出血40～170 ml,平均85 ml。无中转开放手术病例,术后7～12 d康复出院。随访时间5～36个月,平均13个月。12例患者均无腰痛、泌尿系感染、血尿,超声检查患侧无肾盏憩室或结石。结论腹腔镜技术治疗肾盏憩室结石的效果良好,具有创伤小、出血少、可彻底切除憩室及结石等优点。

Objective To evaluate the efficacy of laparoscopic techniques in the treatment of calceal diverticular calculi. Methods Twelve patients with calceal diverticular calculi, male 7 and female 5, average age 37.3 years old, average history 3.6 years, were involved in the study. The patients were accompanied with the syndromes such as waist pain, recurrent urinary infections, and blood urine. The diagnosis was confirmed by CT or IVU. They underwent resection of calceal diverticular or partial renal resection under laparoscopy. The operating time, blood loss, complications and the operative efficacy were recorded. Results The average operating time was 105 min（ 83 - 170 min） ,average blood loss 85 ml （40 - 170 ml）, average diameter of the calceal diverticulum 2. 5 cm, average diameter of the stone 1.8 cm. No case need to transfer to open surgery during the operation. The hospital stay after operation was 7 - 12 days. No complications occurred during the operation. A follow-up of 5 to 36 months （average 13 months）showed no recurrence in all patients, which was confirmed by ultrasound examination. Conclusions Laparoscopic techniques in the treatment of calceal diverticular calculi was characterized by good efficacy, and it has the advantages such as less trauma, less blood loss, completed clearance both calceal diverticular calculi, and so on.