应用自制清石鞘行微造瘘经皮肾镜一期治疗上尿路结石合并同侧单纯性肾囊肿的临床效果分析

目的探讨应用自制可吸引金属清石鞘行微造瘘经皮肾镜一期治疗泌尿系结石合并单纯性肾囊肿的安全性及有效性。方法回顾性分析该院2012年5月-2015年6月收治的单纯性肾囊肿并同侧泌尿系结石的36例患者行微造瘘经皮肾镜手术的临床数据,评价该手术方式的治疗效果。结果所有患者均成功建立经皮肾镜通道,其中单通道30例,双通道6例;手术时间为48～96 min,平均(68.5±5.3)min;术后3例患者出现发热,予以对症治疗后治愈;1例患者出现肾动脉出血,予以高选择性肾动脉栓塞治疗后痊愈。术后复查CT结果显示,36例患者肾囊肿均一期成功处理,34例患者结石取净,另外2例鹿角型结石患者术后仍有较多结石残留,采用2期微造瘘经皮肾镜吸引取石术治疗。结论应用自制金属清石鞘行微造瘘经皮肾镜一期治疗泌尿系结石合并同侧单纯性肾囊肿是一种安全、有效、经济的手术方式。

Application of patented sheath to minimally invasive percutaneous nephrolithotomy for patients with upper urinary tract calculi associated with ipsilateral simple cyst

Abstract: Objective To evaluate the efficacy and safety of invasive percutaneous nephrolithotomy using patented sheath in treating upper urinary tract calculi associated with ipsilateral simple renal cyst. Methods We retrospectively analyzed 198 patients from May 2012 to August 2009 who underwent percutaneous nephrolithotomy using patented sheath under ultrasound guidance for upper urinary tract calculi with simple renal cyst. Then analyze the clinical data of patients, evaluate the therapeutic effect of the surgical procedure. Results The percutaneous renal access was successfully established in 36 patients and immediate lithotripsy was performed, single tract was used in 30 cases, double tract were used in 6 cases. The mean operating time was (68.5 ± 5.3) min, 3 cases patients had high fever after surgery, which were cured after symptomatic treatment, 2 cases of staghorn calculi underwent two-stage operation, 1 cases underwent hyper-selective angio embolization for bleeding control. Conclusion The treatment of upper urinary tract calculi with simple renal cyst by percutaneous nephrolithotomy using patented sheath appears to be safe and efficacious.