超声引导联合内镜监视建立经皮肾镜工作通道

Establishment of Working Tract for Percutaneous Nephrolithotomy Under Ultrasound Guidance Combined With Endoscopic Monitoring

目的探讨超声引导联合内镜监视技术建立经皮肾镜工作通道的安全性和有效性。方法2020年5月~2021年7月,对23例复杂性肾结石采用超声引导联合输尿管软镜监视球囊扩张建立经皮肾镜工作通道。结果23例均顺利完成手术,无通道建立失败。单通道22例,双通道1例。24个通道建立时间4~11 min,(7.0±1.7)min。一期结石清除率91.3%(21/23),2例结石残留,其中1例下盏残留结石长径约17 mm,1个月后行超微肾镜碎石取石术,1例下盏残留结石长约5 mm,无需再次手术。术后发生Clavien-DindoⅠ级、Ⅱ级并发症各2例,无Ⅲ级及以上严重并发症。结论对复杂性肾结石,超声引导联合内镜监视技术建立经皮肾镜工作通道安全、有效,一次成功。

Objective To explore the safety and effectiveness of ultrasound-guided combined with endoscopic monitoring technology in the establishment of percutaneous nephroscope working tract.Methods From May 2020 to July 2021,23 cases of complex renal calculi were treated by ultrasound-guided combined with ureteroscopic monitoring balloon dilatation to establish a working tract for percutaneous nephrolithotomy.Results The operation was successfully completed in all the 23 patients,without tract establishment failure.There were 22 cases of single tract and 1 case of double tracts.The mean establishment time of 24 tracts was(7.0±1.7)min(rang,4-11 min).The primary stone free rate was 91.3%(21/23).Two cases had residual stones:one patient had residual stones with a length of about 17 mm in the lower calyx,which were completely removed by super-mini percutaneous nephrolithotomy after one month;the other patient had residual stones with a length of 5 mm in the lower calyx,which did not need re-operation.The Clavien-Dindo gradeⅠandⅡcomplications occurred in 2 cases,respectively,and there were no serious complications of gradeⅢand above.Conclusions In the treatment of complex renal calculi,the application of ultrasound-guided combined with endoscopic monitoring technology to establish the working tract for percutaneous nephrolithotomy is safe and effective.The tract can be successfully established at one time.