微创经皮肾镜取石术治疗独肾鹿角型肾结石40例报道

A Report on 40 Cases of the Minimally Invasive Percutaneous Nephrolithotomy for Staghorn Calculi of Unitesticle

目的:通过对40例独肾鹿角型肾结石采用微创经皮肾镜取石术治疗来评价其临床疗效。方法:回顾性分析40例独肾鹿角型肾结石患者采用微创经皮肾镜取石术治疗的临床资料。结果:采用单通道治疗27例,双通道治疗13例,全部行一次性取石,残留的微小结石通过术后ESWL基本完全排尽。除1例患者出现术后出血行介入栓塞治疗,其余患者均无严重并发症。结论:微创经皮肾镜取石术治疗独肾鹿角型肾结石较传统开放性肾盂切开取石优势明显,具有创伤小、恢复快、术后并发症少、结石清除率高等优点,但对术者手术操作技术要求较高。术前充分评估患者手术耐受性及风险,手术时机选择,对独肾鹿角型结石的解剖学特点充分了解是减少术中及术后并发症,提高手术疗效的关键。

Objective:To evaluate the clinical curative effect of minimally invasive percutaneous nephrolithotomy(MPCNL) treatment for 40 patients with staghorn kidney stones of unitesticle.Methods:The clinical data of 40 patients were retrospectively analyzed to ascertain the clinical curative effect of minimally invasive percutaneous nephrolithotomy.Results:the mean operation time is obtained and the quantity of bleeding during operation can be estimated.There are 27cases of singlechannel and 13cases of double-channel.All the patients underwent at-a-time stone removal and the residual stones were completely cleared by ESWL after operation.Only one patient suffered hemorrhage after operation,but cured by the intervention embolism treatment and the rest of the patients didn't suffer any serious complications.Conclusion:Minimally invasive percutaneous nephrolithotomy therapy is obviously more advantageous than the traditional open pelviolithotomy,which has advantages of smaller trauma,faster recovery,less postoperative complications and higher rate of stone clearance.But it requires operators to have better operative techniques and patients'tolerance to the operation and the risk should be fully assessed before operation.Choice of proper operation time and agood command of anatomical features of Staghorn Calculi are the key to reduce preoperative and postoperative complications and improve the curative effect of the operation.