腹腔镜联合经皮肾穿刺取石术治疗肾囊肿并肾多发性结石

目的 介绍腹腔镜联合经皮肾穿刺取石术治疗肾囊肿并肾多发性结石的技术要点和初步经验。 方法 选取20例肾囊肿并肾多发性结石患者行腹腔镜联合经皮肾穿刺取石术治疗肾囊肿并肾多发结石。结石最大4x3cm，最小1x0.5cm。先用腹腔镜行肾囊肿去顶术。然后根据术前CTA+CTU片制定手术方案和穿刺部位。在腹腔镜监视下行经皮肾穿刺，建立F18取石通道取石。 结果 20例患者均获得成功。结石全部取尽，手术效果满意。手术平均时间90min。没有出现出血、尿漏、肾盏颈撕裂和输尿管狭窄等严重并发症。术后平均住院时间5d。 结论 腹腔镜联合经皮肾穿刺取石术可以同时处理肾脏多种疾病。在处理肾盏内结石或肾盏颈细长，肾内型肾盂的患者较腹腔镜肾盂切开取石术容易操作，盏颈损伤小和结石清除率高。是腹腔镜肾盂切开取石术有益的补充和支持。

Laparoscopy combined with percutaneous nephrolithotomy lithotomy treatment of renal cysts and multiple stones

Objective  To introduce laparoscopy combined with percutaneous nephrolithotomy lithotomy technical points and the initial experience of the treatment of renal cysts and multiple stones. Methods  20 cases of renal cysts and multiple calculi in patients undergoing laparoscopic percutaneous nephrolithotomy lithotomy joint treatment of renal cysts and multiple stones. Stones the largest 4x3cm, minimum 1x0.5cm. First laparoscopic renal cyst unroofing.Then, according to the CTA CTU tablets preoperative surgical planning and the puncture site. In the laparoscopic monitor the downlink percutaneous nephrolithotomy establish F18 stone path stone. Results  20 patients were all successful. The stones all take the best surgical results were satisfactory. The mean operative time was 90 minutes. No bleeding, urine leakage, the calyceal neck tear and ureteral stenosis and other serious complications. The average hospital stay of five days. Conclusion  The laparoscopic combined with percutaneous nephrolithotomy lithotomy can handle the kidney multiple diseases. Processing calyceal stones or calyceal neck slender, patients with renal pelvis than laparoscopic renal pelvis stone surgery operation easy removal and light neck injury and a high stone clearance. Incision laparoscopic renal pelvis lithotomy useful complement and support.