肠膀胱重建术后尿路结石的微创治疗(附4例报告)

目的：探讨肠膀胱重建术后尿路结石的微创治疗效果。方法：报告4例膀胱癌膀胱全切肠代膀胱术术后并发尿路结石患者的临床资料。结果：1例行经皮肾穿刺肾盂输尿管造影定位下体外冲击波碎石术，结石粉碎并排至结肠膀胱；1例行经皮肾镜碎石术；另2例行经尿道输尿管镜下钬激光碎石术，结石粉碎并取出。结论：肠膀胱重建术后尿结石的发生与尿路感染和手术操作等因素有关，对可控膀胱术后上尿路结石可实施经皮肾镜取石术或尿路造影定位下ESWL治疗，原位回肠代膀胱术后尿路结石可实施腔内碎石治疗。

Microsurgical treatment of urinary calculi after intestinal bladder reconstruction(Report of 4 cases)

Objective:To evaluate the microsurgical treatment of urinary calculi after intestinal bladder reconstruction.Methods:Four cases of post total cystectomy treated from April 2001 to February 2003 were reviewed. Two calculi were found in the right mid-ureter and the right kidney 19 months later and 48 months later with the detinia cecal-ascending colon continent urinary reservoir respectively. The remains calculi were found in the right ureter 28 months later and the ileal pouch neobadder 26 months later with ileal orthotopic neobladder respectively. The clinical data of 4 cases were reviewed and discussed in combination with the relevant literature.Results:One calculus was shocked to pieces and moved to the coloneobladder by extracorporeal shock-wave lithotripsy (ESWL) with seldinger technique of pyeloureterography, another was fragmented by percutaneous nephrolithotomy (PNL), others were gotten ride of using by transurethral vesical Ho:YAG laser lithotripsy.Conclusions:It is fairy good and effective to carry out microsurgical techniques to urinary calculi after intestinal bladder reconstruction.