肾窦内肾盂加肾后下段切开术治疗巨大鹿角形肾结石

Incision of intrarenal sinus supplemented by a postrenal pole segmental incision for the removal of huge staghorn kidney calculus

目的 :探讨复杂性肾结石的手术方法 ,以减少术中出血 ,保护肾功能。 方法:对 4 5例巨大鹿角形肾结石患者采用肾窦内肾盂加肾后下段切开治疗。结果:术中不阻断肾血流 ,术中出血量为 12 0～ 35 0 ml,平均 2 10 ml。手术时间平均为 135 min,取石数量多者达 10 5枚 ,结石体积最大为 8.4 cm× 4 .8cm× 3.6 cm。经 2～ 6年随访 ,4 5例病人的患肾功能恢复良好 ,经 B超或 KU B+IVU复查 ,2例有肾内残留小结石 ,直径 <0 .7cm。结论:肾窦内肾盂加肾后下段切开取石术具有操作简单、手术方便、取净率高、术后并发症少、对肾功能影响小等优点 ,是治疗巨大鹿角形肾结石较好的手术方法之一。

Objective: To evaluate the surgical treatment method for huge staghorn calculus of kidney. Methods: The data of 45 cases treated with an incision of intrarenal sinus supplemented by a postrenal pole segmental incision for the removal of huge staghorn kidney caculus were analysed. Results: the average bleeding was 210 ml; Operation took 135 minutes (mean time); the biggest stone was 8.4 cm×4.8 cm×3.6 cm and in one case,the stones amounted to 105. All the cases were followed up by regular visits for 2 to 5 years. Renal function of all patients improved after operation. Postoperative examination with B ultrasonic and KUB+IVU revealed residual stone in 2 cases, the diameters being less than 0.8 cm. Conclusions: Incision of intrarenal sinus supplemented by a postrenal pole segmental incision for the removal of huge staghorn kidney caculus has the advantage of simple, safe, high single time clearance rate, few postoperative complications and preservation of renal function.