选择F20皮肾通道的微创经皮肾穿碎石手术

目的探讨选择F20皮肾通道进行微创经皮肾穿碎石取石手术的优越性。方法采用经皮肾穿刺碎石取石术处理复杂性肾结石时,皮肾通道扩张至F20,先用标准肾镜、EMS第三代超声负压碎石系统处理主要肾盏、大部分结石,不更换工作鞘改用李逊镜,采用负压弹道碎石处理残余结石。结果 42例复杂性肾结石均采用经皮肾穿碎石术完成,35例患者一期手术完全清除结石,7例残余结石大于1 cm,需二期手术,手术未出现严重并发症。结论通过建立F20皮肾通道,灵活采用李逊镜及标准肾镜进行碎石,提高手术效率,避免并发症,结石清除率高。

Study on advantages of F20 skin renal channel for minimally invasive percutaneous nephrolithotamy

Objective To explore advantages of the choice of F20 skin renal channel for minimally invasive percutaneous nephrolithoto-my. Methods By using minimally invasive percutaneous nephrolithotomy for dealing with complex renal stones,skin renal channel was expanded to F20 with standard nephroscopy,third generation EMS ultrasound ballistic lithotripsy system had been applied for processing most of these stones in main calyces,then changed to Li Xun renal endoscopy without change of job shealth,and pneumatic ballistic lithotripsy was adopted for removal of residual calculi. Results Complex renal stones in 42 cases were completely removed by minimally invasive percutaneous nephrolithotomy. A-mong them,stones were completely removed in 35 patients at first phase of the operation. Residual calculi greater than 1 cm in 7 cases were re-moved by second operation without severe complications. Conclusion By establishing the F20 skin renal channel,flexibly using Li Xun renal en-doscopy and standard renal endoscopy,the efficiency of operation has been improved,and complications have been avoided with high stone clear-ance rate.