URL结合微创PCNL治疗严重输尿管石街

Treatment of the severe ureteral steinstrasse with ureteroscopic lithotripsy and minimally invasive percutaneous nephrolithotomy

目的:总结输尿管镜取石术(URL)结合微创经皮肾穿刺取石术(mini-PCNL)治疗严重输尿管石街的经验。方法:对45例严重输尿管石街(平均长14.3cm)采用输尿管镜下用气压弹道碎石器将结石上推到肾盂后再结合mini—PCNI.顺行取石。结果:所有病例均一次性取尽输尿管内结石,且无输尿管穿孔、狭窄及大出血等并发症发生。结论:URL结合微创PCNL治疗严重输尿管石街,不仅显著缩短了手术时间,降低输尿管损伤的风险性,也可同时处理肾内结石,是一较佳手术方法。

Purpose:To sum up the experiences in the treatment of serious ureteral steinstrasse with uretero-scopic lithotripsy (URL) and minimally invasive percutaneous neprolithotomy (mini-PCNL). Method:From Aug, 1998 to Dec, 2001, 45 patients of severe ureteral steinstrasse(average 14. 3 cm) were managed by mini-PCNL after the stones were pushed back to the renal pelvic under the ureteroscopy and pneumatic lithotripy. Result: All cases were stone-free with one procedure, and no complications such as ureter perforation^ avulsion, severe bleeding happened. Conclusion:Using URL and mini-PCNL to manage serious ureteral steinstrasse can drastically shorten the operative time and lessen morbidity, and undoubtedly this is a excellent modality.