肾上盏入路经皮肾镜取石术治疗多发肾下盏结石

目的探讨肾上盏入路经皮肾镜取石术治疗多发肾下盏结石的安全性及临床疗效。方法 2005年1月～2011年10月,对12例多发肾下盏结石采用B超引导下肾上盏入路经皮肾镜取石术。建立经皮肾通道F16～F24,经皮肾镜下钬激光或EMS碎石清石系统碎石。结果本组12例均成功建立经肾上盏通道,手术时间35～80 min,平均48 min。一期结石清除率83%(10/12),2例术后有结石残留者中,1例术后1周行二次经皮肾镜取石术,1例随访观察。1例术后发热经抗感染治疗后好转,无胸膜及其他重要脏器损伤,无大出血等严重并发症。结论 B超引导下肾上盏入路经皮肾镜取石术治疗多发肾下盏结石安全、有效。

Upper Pole Approach for Percutaneous Nephrolithotomy for Multiple Lower Caliceal Calculi

Objective To evaluate the efficacy and safety of upper pole approach for percutaneous nephrolithotomy(PCNL) in the treatment of multiple lower caliceal calculi.Methods From January 2005 to October 2011,we performed B-ultrasonography-guided PCNL on 12 patients with multiple lower caliceal calculi.Working tunnels F16-F24 were established through the 11th intercostal space,and EMS or holmium laser lithotripsy was used to disintegrate and remove stones by nephroscopy.Results All the operations were successfully completed.The average operation time was 48 minutes(range from 35 to 80 minutes).One-stage stone-free rate was 83.3%(10/12);in the other two patients,one patient received a second PCNL in one week to remove residual stones,another one was followed up.Postoperative fever occurred in one patients,who was then cured by anti-infection therapy.No injuries to the pleura or other organs,or massive hemorrhage occurred.Conclusion B-ultrasonography-guided PCNL is safe and effective for multiple lower caliceal calculi.