摘要
目的:报告联合经皮肾镜取石(PCNL)及输尿管软镜碎石(RIRS)治疗孤立肾鹿角形结石的经验。方法:35例孤立肾鹿角形结石患者结石大小(1 210.6±78.1)mm2,一期PCNL术后使用RIRS处理残留结石,统计分析手术结果和并发症。结果:PCNL平均手术时间为(75.4±19.2)min,RIRS平均手术时间(63.5±17.4)min。PCNL及RIRS术后血红蛋白下降分别是(28±10)和(12±6)g/L。PCNL术后3例患者(8.6%)输血,1例患者(2.9%)因出血行选择性肾动脉栓塞,无其他严重并发症发生。最终结石清除率为85.7%。结论:一期PCNL取出孤立肾鹿角形肾结石的大部分结石,随后采用RIRS处理残留结石,可以达到较高的结石清除率,减少因多通道带来的出血等并发症。
Objective:To report our experience of retrograde intrarenal surgery(RIRS)with flexible ureteroscope as the effective supplementary treatment modality for residual stones following percutaneous nephrolithotomy(PCNL)for staghorn calculi in solitary kidney.Methods:35patients with staghorn calculi,burden(1 210.6±78.1) mm2 in solitary kidney received staging treatment that PCNL followed by RIRS for residual stones.Operative findings and complications were documented and analyzed.Results:The mean operative time was(75.4±19.2)minutes for the first stage PCNL,and(63.5±17.4)minutes for second stage RIRS,respectively.Hemoglobin drop after PCNL was(28±10)g/L and(12±6)g/L after RIRS,respectively.Blood transfusion was noted in 3patients(8.6%),and one patient(2.9%)received selective renal arterial embolization for severe hemorrhage following PCNL,no other severe complication was noted.Final stone free rate was 85.7%.Conclusions:With staging procedures that debulking most partition of staghorn calculi in the first stage PCNL,followed by RIRS with flexible ureteroscope as the supplementary treatment modality for residual stones in second stage,which can get a high SFR and reduce the need for multiple tracts,thereby reducing blood loss and potential morbidity.
出处
《微创泌尿外科杂志》
2013年第6期381-383,共3页
Journal of Minimally Invasive Urology
关键词
输尿管软镜
逆行肾内手术
经皮肾镜取石术
鹿角形结石
孤立肾
flexible ureteroscopy
percutaneous nephrolithotomy
retrograde intrarenal surgery
staghorn calculi
solitary kidney
