后腹腔镜辅助小切口配合钬激光碎石治疗孤立肾鹿角形结石疗效评价

Retroperitoneoscopic small incision combined with holmium laser lithotripsy in the treatment of staghorn calculi in solitary kidney

目的 探讨和研究后腹腔镜辅助小切口配合钬激光碎石治疗孤立肾鹿角形结石的安全性和有效性。方法 回顾性分析2013年2月至2020年4月江苏省昆山市第一人民医院收治的21例孤立肾鹿角形结石行后腹腔镜辅助小切口配合钬激光碎石术的临床资料,对患者的手术时间、术中出血量、结石清除率、术后感染等指标进行分析。结果 21例患者手术均顺利完成,手术平均时间约120min,术中出血量80~180mL,术后无再发出血、无尿漏、无严重感染,手术后平均住院时间7d,结石清除率90.48%(19/21),随访1~12个月,肾功能均有不同程度的改善,结石清除效果满意。结论 孤立肾合并鹿角形结石采用后腹腔镜辅助小切口配合钬激光碎石术,具有术中出血少、取石干净、感染风险低、术后恢复快、肾功能改善明显、安全性高等优点,是一种比较理想的手术方法。

Objective To evaluate the safety and efficacy of retroperitoneoscopic small incision combined with holmium laser lithotripsy in the treatment of staghorn calculi in solitary kidney.Methods The clinical data of 21 cases were reviewed.The operation time,intraoperative blood loss,stone-clearance rate,postoperative infection and other indicators were analyzed.Results All operations were successful.The average operation time was 120 min,and intraoperative blood loss ranged from80 to 180 mL.No postoperative complications such as rehemorrhage,urine leakage or serious infections were observed.The length of hospitalization was 7 days.The stone-clearance rate was 90.48%(19/21).During the follow-up of 1 to 12 months,all patients' renal function was improved.B-ultrasound showed no residual stones.Conclusion This procedure has advantages of small volume of bleeding,high stone-free rate,low infection risk,quick postoperative recovery,obvious improvement of renal function and high safety,which make it an ideal surgical method.