肾盂切开联合气压弹道碎石治疗复杂性鹿角形肾结石

Pneumatic lithotripsy for huge staghorn renal stones through pyelostomy

目的探讨肾盂切开联合气压弹道碎石技术治疗复杂性鹿角形肾结石的疗效。方法对43例复杂性鹿角形肾结石患者行肾盂切开联合气压弹道碎石术的临床资料进行分析总结。结果43例行肾盂切开联合气压弹道碎石取石均成功,5例因完全肾内型肾盂致使无法显露肾窦内肾盂或术中碎石角度困难而改行肾实质小切口联合气压弹道碎石取石。术中不阻断肾蒂血流,无大出血,无肾盂黏膜撕裂,全组无输血,平均手术时间为136min。40例随访8个月-3年,平均21个月,有1例结石复发,经体外震波碎石(ESWL)后排净。结论该术式将泌尿外科腔镜气压弹道碎石技术运用到开放手术中,使术式操作简单、安全、出血少、对肾脏损害轻微,是治疗复杂性鹿角形肾结石比较理想的手术方法。

Objective To investigate the operative treatment of pneumatic lithotripsy for huge staghorn rehal stones through pyelostomy. Methods The clinical data of 43 cases who were treated by pneumatic lithotripsy for huge staghorn renal stones through pyelostomy. Results 43 patients were successfully removed stones by pneumatic lithotripsy for huge staghorn renal stones through pyelostomy. 5 patients were removed stones by renal parenchyma discission with mini - incision in combination with pneumatic lithotripsy because of complex condition. During the operation, the renal blood flow was not blocked, and all the patient did not have massive haemorrhage, laceration of pelvis mueosa and blood transfusion. The average operation time was 136 minutes. 40 patients had been followed up from 8 months to 3 years, averaged 21 months. Only one patient was found to recur, but was healed by ESWL. Conclusion Pneumatic lithotripsy for huge staghorn renal stones through pyelostomy is simple, safe, less blooding and less damage for kidney, and it is a ideal operation for huge staghom renal stones.