经皮肾穿刺取石和肾盂肾下盏切开取石治疗复杂性肾结石

目的提高治疗复杂性肾结石的效果。方法对626例复杂性肾结石患者,606例采用经皮肾穿刺取石(PCN-L),20例采用改良式肾盂肾下盏联合切开取石。结果606例PCN-L中一次取净结石86%,需再次取残石14%。改良式肾盂肾下盏联合切开取石20例,术中取净结石16例,占80%,残留结石4例,占20%。结论PCN-L对肾损伤小、恢复快,可经原通道反复取石。改良式肾盂肾下盏联合切开取石,主要处理位于肾中下盏复杂性肾结石。因此,只要技术条件成熟,PCN-L应作为首选处理肾结石的主要方法。

Treatment of complicated renal calculi with PCN-L and lower renal calices with pyelolithotomy

Objective To improve the efficacy of treatment of complicated renal calculi. Methods In a total of 626 patients, 606 were treated with percutaneous nephrolithotomy (PCN-L) and 20 with modified incision of renal calices and pyelolithotomy. Results Of the 606 cases, 86% were stone-free after the 1st session, and another 14% were stone-free after a 2nd session. The stones were cleared off in 16 of the 20 patients with modified incision of lower renal calices with pyelolithotomy. Conclusion PCN-L is less invasive and may render stone-free through pro-pathway repeatedly, while modified incision of lower renal calices with pyelolithotomy mainly treats mid and lower renal calices calculi. Therefore, PCN-L is ideal operative choice for renal calculi as long as it is available.