Ⅱ期经皮肾镜碎石联合逆行输尿管软镜治疗PCNL术后残余结石

Eliminating residual renal calculi after PCNL by percutaneous nephrolithotomy with retrograde flexible ureteroscopy in second stage

目的:探讨Ⅱ期经皮肾镜碎石联合逆行输尿管软镜处理PCNL残余结石的有效性及安全性。方法:回顾性分析2013年3月~2016年9月间使用经皮肾镜联合逆行输尿管软镜Ⅱ期处理PCNL残余结石患者的临床资料。患者取改良的半截石斜卧位,两名医师分别采用肾镜和逆行输尿管软镜进行碎石操作。结果:36例病例中,残余结石STONE评分为6.7分,平均耗时26.3min,Ⅱ期术后结石总清除率为94%(34/36),不伴有明显并发症。结论:Ⅱ期经皮肾镜联合逆行输尿管软镜处理PCNL残余结石能充分发挥现有技术和器械的优点,其安全性高,可行性强。

Objective:To investigate the efficiency and safety of percutaneous nephrolithotomy with retrograde flexible ureteroscopy in the treatment of residual renal calculi after PCNL in second stage.Methods:We retrospectively reviewed the cases undergoing second-stage percutaneous nephrolithotomy with retrograde flexible ureteroscopy between March 2013 and September 2016.The patients were placed in the Galdakao-modified Valdivia supine position.Two urologists manipulated nephroscopy and regtrograde flexible ureteroscopy respectively in the same time.Results:Thirty-six cases were investigated,and the residual calculi S.T.O.N.E.scores were 6.7in average.The procedure lasted 26.3 min.The stone free rate was 94%(34/36)without significant complications.Conclusions:Treating residual renal calculi after PCNL by percutaneous nephrolithotomy with retrograde flexible ureteroscopy is feasible and safe.It can make full use of the advantage of different instruments.