肾窦内肾盂加肾后下部切开治疗巨大鹿角形肾结石

Incision of the intrarenal sinus supplemented by a postrenal pole segmental incision for the removal of huge kidney calculus

目的 提高巨大鹿角形肾结石的手术疗效。 方法 对 2 0 2例巨大鹿角形肾结石患者行肾窦内肾盂加肾后下部切开取石术的临床资料进行分析总结。 结果 术中不阻断肾蒂血流 ,手术平均耗时 14 8min ,术中平均出血 110ml,术后平均住院 12 .8d。 2 0 2例中取出结石最大 9.8cm× 5 .0cm× 3.2cm ,结石最多 1例达 74枚。 98例获随访 ,术后 3个月KUB +IVU或B超检查见肾内残留小结石 9例 ,直径均 <0 .8cm。 结论 该术式操作简单、出血少、取石干净、对肾功能影响小 ,是治疗巨大鹿角形肾结石较理想的手术方法之一。

Objective To improve the surgical technique for the removal of huge staghorn stones. Methods 202 cases treated with an incision of the intrarenal sinus supplemented by a postrenal lower pole segmental incision for the removal of huge kidney stones were studied. Results The biggest stone was 9.8 cm×5.0 cm×3.2 cm and in one case the stones amouned to 74. The average postoperative hospitalization days was 12.8. Postoperative examination with KUB+IVU or B ultrasound revealed residual stone in 9 cases, the diameters being less than 0.8 cm. Conclusions The procedure needs no interruption of renal pedical and with the advantages of simple,less bleeding,complete removal of calculus,and preservation of renal function.