盏颈切开术治疗肾内型肾盂复杂肾结石

目的　探讨盏颈切开取石术治疗肾内型肾盂复杂肾结石的疗效。　方法　对 5 2例肾内型肾盂复杂肾结石合并上盏和 (或 )下盏重度肾积水患者行经盏颈切开取石术。其中男 38例 ,女 14例 ,平均年龄 4 3岁。结石平均直径 4 .2cm。　结果　结石一次取净 4 4例 ,残余结石 8例 ,采用输尿管镜经肾造瘘瘘道行气压弹道碎石、取石 ,4例结石取净 ,4例仍有残余结石 ,行ESWL术。术中均未输血 ,术后无继发出血。 2 4例获随访 ,术后 6个月至 4年KUB加IVU复查 ,手术侧肾积水减少 ,无肾盂肾盏狭窄及结石复发。　结论　盏颈切开取石术具有术中出血少 ,肾集合系统破坏小 ,肾功能受损轻和术后并发症少等优点。适用于肾内型肾盂复杂性肾结石并发上盏和 (或 )下盏重度肾积水的治疗。

Incision of renal calices for the treatment of complex intrarenal sinus renal calculi

Objective To explore the effect of incision of the cervix renal calices for the treatment of complex intrarenal sinus renal calculi. Methods 52 cases of complex intrarenal sinus renal calculi with upper and/or lower calyx serious hydrops treated by incision of the cervix renal calices were studied.There were 38 men and 14 women.The mean age was 43 years (range,21 to 70 years).The mean diameter of the stones was 4.2 cm. Results The stones were totally removed in 44 cases.8 cases with residual stones were treated by percutaneous nephrolithotomy. The residual stones were totally removed in 4 cases while other 4 cases accepted further treatment with extracorporeal shock wave lithotripsy (ESWL).No blood transfusion and postoperative bleeding were observed.24 cases were followed up of 0.5 to 4 years.KUB plus IVU were conducted postoperatively which showed improved hydronephrosis.No intrarenal stricture and renal calculi recurrence were observed. Conclusions The procedure has advantages of less bleeding,preservating more renal function,less postoperative complications,which has a good application in the treatment of complex intrarenal sinus renal calculi with upper and/or lower calyx serious hydrops.