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作 者:王小祥[1] 祁乐中[1] 刘林涛[1] 贺兴军[1]
机构地区:[1]江苏省扬州市第一人民医院泌尿外科,225001
出 处:《中华腔镜泌尿外科杂志(电子版)》2012年第4期35-37,共3页Chinese Journal of Endourology(Electronic Edition)
摘 要:目的探讨后腹腔镜下肾窦内肾盂切开取石治疗肾鹿角状及多发性结石的疗效。方法肾多发及鹿角状结石患者13例,其中男8例,女5例。平均年龄41岁。结石直经1.8~2.7cm。常规采用3个Trocar,于腹膜后间隙建立气腹,紧贴肾盂外膜向肾窦内分离,暴露出肾盏漏斗部,切开取石,输尿管内置入双J管,4-0可吸收线缝合肾盂切口,冲洗、放置引流管。术后5~6d拔出引流管。4周左右拔出双J管。结果 13例手术均获成功,平均手术时间96min。术后平均住院7d。随访3~18个月,腹部平片(KUB)及静脉肾盂造影(IVU)示无结石残留,肾盂出口输尿管无狭窄,双肾输尿管均显影。结论腹腔镜下肾窦内肾盂切开取石术是治疗肾结石可选择的一种微创手术,该术式能同期处理上尿路合并症,可部分替代开放性手术。Objective To evaluate the clinical efficacy and safety of retroperitoneal laparoscopic pyelolithotomy in the treatment of intrarenal pelvic staghom calculus or multiple renal calculus. Methods Thirteen patients (8 males and 5 females) with average age of 41 years were treated, The diameters of cal- culi were from 1.8 cm to 2.7 cm. Three trocars were used in this procedure as routine. The renal sinus was exposed by separating the pelvis from outside to inside until reaching the infundibulum of the renal calyx. Then the renal calyx was cut and the calculus was dislodged. Double J stent was inserted into the ureter and the incision of pelvis was closed with 4-0 absorbable suture. The drainage tube was pulled out 5-6 d post- operatively according to the drainage quantity. Double J stent was pulled out 4 weeks after surgery. Results All 13 procedures were successfully completed. The average operation time was 96 min and the average postoperative hospital stay was 7 days. During the 3-18 months follow up, KUB and IVU showed no upper urinary tract stricture and no residual stones. The kidney function was improved in all eases. Conclusions Laparoseopie pyelolithotomy is an alternative minimally invasive approach for renal calculus, by which pro- cedure the upper urinary tract complications can be treated concomitantly, thus it can partially replace open surgery.
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