后腹腔镜下肾窦内肾盂切开取石术治疗复杂肾结石的临床研究

Retroperitoneoscopic intrasinusal pyelolithotomy for complex renal calculus

目的：探讨后腹腔镜肾窦内肾盂切开取石术治疗复杂肾结石的可行性及其疗效。方法采用后腹腔镜途径，对30例复杂肾结石患者行肾窦内肾盂切开取石术治疗。结果26例均经后腹腔镜一次性取石成功；4例中转开放性手术取石；2例术后并发漏尿，均经持续后腹腔引流后，分别于术后第12天及19天痊愈出院；3例结石残存。26例术后患者6～12个月获随访，受访病例原肾功能的情况均有不同程度改善，无尿路感染发生，无肾盂输尿管狭窄改变等。结论后腹腔镜肾窦内肾盂切开取石术治疗复杂肾结石，是一种安全有效手术方法。具有一定的实用性，可部分替代经皮肾穿碎石术。

Objective To investigate the feasibility and efficacy of retroperitoneoscopic intrasi-nusal pyelolithotomy for complex renal calculus.Methods Retroperitoneoscopic intrasinusal pyelolithoto-my was carried out in 30 patients with complex renal calculus.Results Of all the cases,26 patients un-derwent retroperitoneoscopic intrasinusal pyelolithotomy successfully and 4 cases were converted to open operation.Two cases of postoperative urine leakage were treated by continuous drainage and got cured at the twelfth and nineteenth day after surgery,respectively.Three cases had residual stones.Twenty-six cases were followed up for six to twelve months and their primary renal function improved without urinary tract infection or ureteropelvic stenosis.Conclusion Retroperitoneoscopic intrasinusal pyelolithotomy is safe and effective in the treatment of complex renal calculus.It has certain practicability and might replace per-cutaneous lithotripsy partially.