移植肾尿路结石的腔内治疗

目的探讨腔内治疗移植。肾尿路结石的效果和策略。方法采用腔内技术治疗13例移植。肾尿路结石，其中。肾结石3例，金属支架结石1例，输尿管结石9例，合并输尿管口狭窄2例。结石最大直径8～48mm，接受肾移植的时间1个月～8年。结果3例。肾结石和1例金属支架结石行经皮微造瘘输尿管镜取石术成功取石。4例输尿管结石行逆行输尿管镜取石治疗；3例行经皮顺行输尿管镜取石成功，其中1例合并移植输尿管口狭窄者同时行内切开取石；1例移植输尿管口狭窄合并下端结石者，改行开放手术；1例输尿管结石直接行体外冲击波碎石术2次后排净结石。术后随访1～8年，人肾存活均良好，12例患者。肾功能恢复正常，无结石复发。结论移植肾尿路结石处理应选择创伤小、效果好的腔内微创治疗，尽可能保护。肾功能。

Endoscopic treatment of urinary calculi in allograft kidneys

ObjectiveTo evaluate the efficacy and strategies of endoscopic treatment for urinary calculi in allograft kidneys.MethodsOverall,13 cases of urinary calculi in allograft kidneys were treated by endoscopic technique.Among them,3 cases had renal stones;1 case had netlike shape-memory alloy stent stones;9 cases had ureteral stones;and 2 cases had concomitant ureteral orifice stricture.The stone size ranged from 8 mm to 48 mm in greatest dimension,and the time after transplantation ranged from 1 month to 8 years.ResultsMinimally percutaneous nephrostolithotomy (mini-PCNL) were performed in 4 cases ( 3 of renal stones and 1 of alloy stent stones); and 8 cases underwent retrograde ureteroscopy and percutaneous antegrade ureteroscopy.All the procedures were successful.Of the 2 cases of lower ureteral stone with orifice stricture,one underwent endoureterotomy and the other underwent open surgery after failed retrograde ureteroscopy.The patients were followed up for 1-8 years;and all the patients and transplanted kidneys survived well. The kidney function returned to normal in 12 patients and no stones recurred.ConclusionsDue to its less trauma and excellent outcome, minimally invasive endoscopy should be chosen for treatment of urinary calculi in allograft kidney so as to protect kidney function as far as possible.