Objective:Renal collecting system macroscopically consists of minor calyx,major calyx,renal pelvis and ureter.Stone in renal collecting system is a common presentation in everyday urological practice.The prevalence of...Objective:Renal collecting system macroscopically consists of minor calyx,major calyx,renal pelvis and ureter.Stone in renal collecting system is a common presentation in everyday urological practice.The prevalence of renal calculi ranges from 4%to 20%in different geographical distribution.Anatomical variation in renal collecting system plays a significant role in formation of calculi in its parts.The large extra renal pelvis leads to stagnation of urine for longer durations and formation of stones.The stone free rate after percutaneous nephrolithotomy and extra corporeal shock wave lithotomy is significantly related to anatomical factors,particularly the type of renal pelvis and dimensions(length and width)of lower infundibulum.Previous authors described the morphology of pelvicalyceal system in a highly variable manner and the available anatomical description of pelvicalyceal system is contradictory and incomplete.Hence an attempt has been made to provide the precise anatomy of pelvicalyceal system in adult human kidneys.Methods:We studied 196 formalin embalmed kidneys to note the number of infundibulum,major and minor calyces.The location and shape of pelvis were also studied.Results:The intra-renal pelvis was narrow and had funnel shaped appearance in 95 of total 196(48.5%)specimens,and the extra-renal pelvis was dilated as balloon shaped in 43 of 196(21.9%)specimens.In 41(20.9%)specimens,the renal pelvis was having partially intra-and extra-renal in location.Bilateral symmetry was found in only 27.1%of 196 renal collecting systems.The length of lower infundibulum was more than 22 mm in 19(9.7%)of 196 cases which directly affects the stone clearance rate during open and endoscopic surgeries on pelvicalyceal system.Conclusion:This study provides the accurate morphological details of the shape and dimensions of renal pelvicalyceal system to help the urologists and nephrologists.展开更多
目的：探讨直径≤1．5 cm 的肾盂结石最佳微创治疗方法。方法直径≤1．5 cm 肾盂结石90例，其中47例行逆行途径的肾内手术（RIRS），采用输尿管硬镜联合软镜钬激光碎石，43例采用经皮肾镜碎石术（PCNL）。比较分析两种方法治疗结石的手...目的：探讨直径≤1．5 cm 的肾盂结石最佳微创治疗方法。方法直径≤1．5 cm 肾盂结石90例，其中47例行逆行途径的肾内手术（RIRS），采用输尿管硬镜联合软镜钬激光碎石，43例采用经皮肾镜碎石术（PCNL）。比较分析两种方法治疗结石的手术时间、碎石成功率、术后住院时间和并发症。结果RIRS 组和 PCNL 组结石平均直径分别为1．2 cm（1．0～1．5 cm）及1．3 cm （1．0～1．5 cm）。RIRS 组手术均顺利完成，其中32例手术过程中换用输尿管软镜击碎冲入肾盏的结石。平均手术时间44 min（25～70 min），一期结石清除率达95．74％（45／47），术后发热 2例，血红蛋白和红细胞压积轻度下降，血红蛋白平均下降（0．18±0．06）g／L，红细胞压积平均下降0．11％。所有患者均未发生并发症。PCNL 组手术均顺利完成，平均手术时间70 min（45～90 min），一期结石清除率达95．35％（41／43），术后发热 2例，血红蛋白平均下降（17．25±6．70）g／L，红细胞压积平均下降5．62％。PCNL2例出现明显术中、术后出血。结论对于直径≤1．5 cm 的肾盂结石，RIRS组具有良好的清石率，其经自然腔道内镜手术的特点使其创伤小，主要并发症发生率明显低于 PC-NL，手术时间及住院时间均具有明显优势。对于直径≤1．5 cm 的肾盂结石，应首选 RIRS 手术。展开更多
文摘Objective:Renal collecting system macroscopically consists of minor calyx,major calyx,renal pelvis and ureter.Stone in renal collecting system is a common presentation in everyday urological practice.The prevalence of renal calculi ranges from 4%to 20%in different geographical distribution.Anatomical variation in renal collecting system plays a significant role in formation of calculi in its parts.The large extra renal pelvis leads to stagnation of urine for longer durations and formation of stones.The stone free rate after percutaneous nephrolithotomy and extra corporeal shock wave lithotomy is significantly related to anatomical factors,particularly the type of renal pelvis and dimensions(length and width)of lower infundibulum.Previous authors described the morphology of pelvicalyceal system in a highly variable manner and the available anatomical description of pelvicalyceal system is contradictory and incomplete.Hence an attempt has been made to provide the precise anatomy of pelvicalyceal system in adult human kidneys.Methods:We studied 196 formalin embalmed kidneys to note the number of infundibulum,major and minor calyces.The location and shape of pelvis were also studied.Results:The intra-renal pelvis was narrow and had funnel shaped appearance in 95 of total 196(48.5%)specimens,and the extra-renal pelvis was dilated as balloon shaped in 43 of 196(21.9%)specimens.In 41(20.9%)specimens,the renal pelvis was having partially intra-and extra-renal in location.Bilateral symmetry was found in only 27.1%of 196 renal collecting systems.The length of lower infundibulum was more than 22 mm in 19(9.7%)of 196 cases which directly affects the stone clearance rate during open and endoscopic surgeries on pelvicalyceal system.Conclusion:This study provides the accurate morphological details of the shape and dimensions of renal pelvicalyceal system to help the urologists and nephrologists.
