微创经皮肾镜联合盏颈切开治疗小儿肾盏憩室

Combining minimally invasive percutaneous nephrolithotomy with calyceal diverticulum light neck cutting for the treatment of children with calyceal diverticulum

目的探讨微创经皮肾镜联合肾盏憩室盏颈切开术,治疗小儿肾盏憩室的临床疗效。方法回顾分析采用微创经皮肾镜联合肾盏憩室盏颈切开术,治疗小儿肾盏憩室6例患者的临床资料;采用B超定位引导穿刺目标肾盏,同时以柱状电极切开盏颈部狭窄;统计手术时间、术中出血量、住院时间以及术后并发症。结果 6例肾盏憩室患者均I期微创经皮肾镜成功进入目标肾盏,并行柱状电极切开盏颈部狭窄。手术时间为35～120 min,平均50 min;术中出血35～100 mL,平均45 mL,术后7～10 d出院。术后复查2例患者肾盏憩室消失,3例憩室明显缩小,1例憩室缩小不明显。结论微创经皮肾镜联合盏颈切开,治疗小儿肾盏憩室创伤小,安全、有效。

Objective To investigate combining minimally invasive percutaneous nephrolithotomy with calyceal diverticulum light neck cutting clinical efficacy for the treatment of children with calyceal diverticulum. Methods Retrospectively analysising clinical data of patients combining minimally invasive percutaneous nephrolithotomy with calyceal diverticulum light neck cutting clinical from May 2009 to October 2012 in our hospital . The direct puncture goals calyceal was guided by B - ultrasonic wave and columnar electrodes opened stenosis in tne neck. Statistical operation time, intraoperative blood loss, hospital stay and postoperative complications. Results 6 cases of patients with primary renal calyceal diverticulum of minimally invasive percutaneous nephrolithotomy successfully entered the target renal calices and columnar elec- trode lamp narrow neck incision. The operative time was 35 - 120 min, an average of 50 min; blood loss of 35 to 100 ml, with an average of 45 ml. No serious postoperative complications ,no conversion to open surgery cases discharged after 7 -10 d. After treatment of 2 patients of renal calyceal diverticulum disappeared ,3 patients with diverticulum narrowed significantly and 1 cases of diverticular narrowing is not obvious. Conclusion minimally invasive percutaneous nephrolithotomy with calyceal diverticulum light neck cutting is Minor trauma, safe, effective for patients.