18例肾盏憩室结石的微创经皮肾穿刺取石治疗

目的：探讨微创经皮肾穿刺取石治疗肾盏憩室结石的有效性与安全性。方法：总结本院18例采用微创经皮肾穿刺取石治疗肾盏憩室结石患者的临床资料，其中男12例，女6例，平均35.2岁。肾上盏结石10例，肾中盏结石5例，肾下盏结石3例。采用B超或X线定位引导穿刺结石所在肾盏憩室，建立通道，应用弹道碎石，同时以筋膜扩张器扩张憩室流出道，并将16 F肾造瘘管留置于肾盂内。结果：17例行一期碎石取石，余1例患者行二期微创经皮肾镜碎石取石。手术时间为（65±20）min；术中出血（75±12）mL。无术后严重并发症发生，无中转开放手术病例。结论：微创经皮肾镜碎石术创伤小，清除结石的同时可以应用筋膜扩张器扩张肾盏憩室流出道，是有症状的肾盏憩室结石患者的一种安全有效治疗手段。

Minimally Invasive Percutaneous NephroHthotripsy for Treatment of 18 Cases of Caliceal Diverticular Calculi

Objective：To investigate the safety and feasibility of minimally invasive percutaneoua nephrolithotripsy （MPCNL）in the treatment of caliceal diverticular calculi.Method：18 patients（12 males and 6 females,average age 35.2 years old）who had MPCNL treatment of symptomatic caliceal diverticular calculi were retrospectively analyzed.Stone-bearing caliceal were the upper calices in 10 cases and midge calices in 5 patients,and other 3 patients were in the lower calices. Stones were removed intact or fragmented with lithotripsy by MPCNL under the B type Ultrasound guidance or X-ray in all patients,and the caliceal diverticular necks were dilated with dilator and placed with a 16 F nephrostomy tube for several days.Result：17 cases had a MPCNL and were rendered stone-free at one session,only 1 case needed a second nephroscopy for the residual stone.The average operating time was（65±20）min and the average blood loss was（75±12）mL.No severe complications occurred in all patients.Nobody was transfered to open surgery during the operation.Conclusion：MPCNL may be an effective and feasible treatment option with less invasion and high stone-free rate for symptomatic caliceal diverticular calculi in selective cages.