软硬镜联合钬激光微创治疗复杂性肾结石40例

Minimally invasive surgery combined with holmium laser for the treatment of complex renal calculi:a report of 40 cases

目的:探讨微创经皮肾镜钬激光碎石取石联合输尿管软镜钬激光碎石取石治疗复杂性肾结石的临床疗效及安全性。方法:采用微创经皮肾联合输尿管软镜钬激光碎石取石治疗复杂性肾结石40例,其中完全性铸型结石15例,多发及不完全性铸型结石25例,直径2.5~4.0cm,一期顺行输尿管软镜碎石取石8例,二期逆行输尿管软镜钬激光碎石取石32例。结果:所有病例均成功一期完成微创经皮肾碎石取石术,软硬镜联合碎石手术终结后后复查X线腹部平片了解残石情况,清石率达90%。未出现气胸、肠道损伤、大出血或尿源性脓毒血症等严重并发症。结论:微创经皮肾镜取石联合输尿管软镜治疗复杂性肾结石安全、有效、清石率高。

Objective： To investigate the effectiveness and safety of minimally invasive percutaneous laser lithotripsy combined with holmium laser lithotripsy for the treatment of complex renal calculi.Methods： Using minimally invasive percutaneous nephrolithotomy combined with flexible ureteroscopic holmium laser lithotripsy for complex renal calculi in 40cases,including 15 cases with complete staghorn calculi, multiple and incomplete staghorn calculi in 25 cases, 2.5 - 4.0cm in diameter, a period of anterograde flexible ureteroscopic lithotripsy in 8 cases, two during the retrograde ureteroscope holmium laser lithotripsy in 32 cases.Results： All cases were successfully completed a minimally invasive percutaneous renal lithotripsy, and after the end of the combination of the hard and soft lithotripsy, X-ray abdominal X-ray plain film to understand the situation of the residual stone, the stone removal rate of 90%.No serious complications of pneumothorax, intestinal injury, bleeding or of urosepsis.Conclusion： minimally invasive percutaneous renal lithotripsy combined with ureteral soft mirror in the treatment of complex renal calculi is safe, effective and clear stone rate is high, it is worthy of clinical application.