开放手术后复发肾结石的微创经皮肾取石术治疗

Treatment of renal calculi after open surgery with minimally invasive percutaneous nephrolithotomy

目的探讨微创经皮肾取石术(MPCNL)治疗开放手术后复发肾结石的可行性与疗效。方法对50例开放手术后复发肾结石患者施以MPCNL治疗,其中全鹿角状结石18例,部分鹿角状结石20例,多发性结石12例。结果50例手术均成功,平均手术时间92 min;36例一期MPCNL取净结石(72.0%),10例接受二期MPCNL,术后结石清除率84.0%。7例术后发热,2例需要输血,1例气胸,经保守治疗均好转。结论MPCNL治疗开放手术后肾结石创伤小、并发症少、恢复快、结石清除率高,可以作为开放手术后复发肾结石的首选治疗方案。

Objective To report our experience with minimally invasive percutaneous nephrolithotomy （MPCNL） in treating patients with renal calculi after open operation, and to evaluate the feasibility and efficiency of this procedure. Methods Fifty patients with renal calculi（ 18 cases with complete staghom calculi ,20 cases with partial staghom calculi and 12 cases with multiple renal calculi）were treated by MPCNL. Results All operations were successful, and the mean operating time was 92 minutes. Thirty six cases（ 72.0% ）were rendered stone free after the first session, 10 cases had a second -look MPCNL and the clearance reached 84.0%. Postoperative fever was seen in 7 cases, 2 cases required transfusion, and pneumothorax was happened in 1 case. Conclusion MPCNL is an effective and feasible therapeutic option for patients with renal calculi after open operation for its advantages of less invasiveness and complications, higher clearance rate and shorter duration for hospitalization. Therefore it may be chosen as the first choice for treatment of patients with renal calculi.