微创经皮肾穿刺取石术治疗肾盏憩室结石

目的 探讨微创经皮肾穿刺取石术治疗有症状肾盏憩室结石的可行性与临床疗效。方法 2001年2月，2006年4月12例肾盏憩室结石患者接受微创经皮肾穿刺取石术治疗。C臂X光辅助下穿刺肾盏憩室建立16F皮肾通道后。8．0／9．8F输尿管硬镜下碎石取石。术中视具体情况，采取电凝憩室囊壁或扩张憩室盏颈。结果 12例患者中，1例穿刺失败改开放手术，11例微创经皮肾穿刺取石术中穿刺憩室结石顺利取石。平均手术时间为72min。平均住院天数为10d。术中平均出血量为240mL。1例患者术后输血200mL，无其他严重并发症。术后随访1个月～2年中10例患者症状完全消失，2例缓解。结论 微创经皮肾穿刺取石术可以选择性作为治疗有症状肾盏憩室结石的一种有效方法，具有创伤小、并发症少、恢复快、结石清除率高等优点。

Treatment of renal caliceal diverticular calculi with minimally invasive percutaneous nephrolithotomy

Objective] To investigate the safety and feasibility of MPCNL in treating calyceal dlverticular calculi. Methods] From February 2001 to April 2006, 12 patients with a symptomatic calyceal diverticular calculi received MPCNL. After a 16F pereutaneous tract established under C ann X-ray apparatus, renal stones was fragmented by a 8/9.8F rigid ureteroscope. At the mean time, the diverticulum was managed by electric coagulation or dilation the diverticular neck. Results] 11 cases had a MPCNL and were rendered stone-Free at one session, and 1 case had an open operation treatment for the failure of percutaneous puncturation. Mean operative time was 72 minutes, mean hospital stay was 10 days, blood loss volume was 240 mL, blood transfusions was needed for 200 mL in 1 case. In a follow up of 1 month to 2 years, 10 cases were healed and 2 cases had released the symptom. Conclusion] MPCNL was an effective and feasible treatment option for symptomatic caliceal diverticular calculi in selective cases with the advantage of fewer trauma, less complication, shorter hospital stay time and higher clearance over open operation.