后腹腔镜肾盂切开取石联合膀胱软镜钬激光碎石取石术治疗复杂性肾结石  

Retroperitoneal laparoscopic pyelolithotomy combined with holmium laser lithotripsy under flexible cystoscopy in treatment of complicated nephrolithiasis

作　　者：肖亚[1] 付卫华[1] 张艮甫[1] 王平贤[1] 范明齐[1] 冯嘉瑜[1] 钟晓[1] 黄赤兵[1] 

机构地区：[1]第三军医大学新桥医院泌尿外二科,重庆400037

出　　处：《局解手术学杂志》2014年第5期474-476,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的分析后腹腔镜肾盂切开取石联合膀胱软镜钬激光碎石取石术治疗复杂性肾结石的有效性和安全性。方法2012年1月至2014年1月对37例复杂性肾结石患者行后腹腔镜下肾盂切开取石联合膀胱软镜钬激光碎石取石术;统计并分析患者基本资料、手术时间、术中出血量、术后住院时间、一期清石率、围手术期并发症、术后复查等情况。结果 37例患者顺利完成手术。平均结石直径(2.8±0.9)cm,手术时间(89±24)min,术中出血量(21.3±7.7)mL,术后住院时间(6.8±1.7)d,一期清石率为94.6%,围手术期1例发热,1例尿漏,经保守治疗均痊愈。术后6个月对所有患者进行随访,肾功能均正常,无结石复发及上尿路梗阻,肾积水均较术前明显减轻。结论腹腔镜肾盂切开取石联合膀胱软镜钬激光碎石取石术是治疗复杂性肾结石安全、高效的手术方式。Objective To evaluate the efficacy and safety of retroperitoneal laparoscopic pyelolithotomy （ RLP） combined with holmium laser lithotripsy under flexible cystoscopy in the treatment of complicated nephrolithiasis. Methods The retrospective analysis was made on the clinical data of 37 patients who underwent RLP and holmium laser lithotripsy under flexible cystoscopy for complicated nephrolithiasis from January 2013 to January 2014. The clinic parameters involved basic data of patients,operational time,blood loss,post-operative hospital stay,the status of stone-free,perioperative complications,and the follow-up data of patients were observed. Results No patient was converted to open surgery. The mean stone size was （2. 8 ± 0. 9） cm in diameter,operational time was （89 ± 24） min,blood loss was （21. 3 ± 7. 7） mL,post-operative hospital stay was （6. 8 ± 1. 7） d,the stone removal rate in one session was 94. 6%. One case occurred urinary leakage,1 case occurred fever after operation,who were all recovered through conservative treatment. All cases were followed up at the sixth months after operation. Conclusion RLP combined with holmium laser lithotripsy under flexible cystoscopy is effective and safe for the treatment of com-plicated nephrolithiasis.

关 键 词：腹腔镜 膀胱软镜 肾结石 一期清石率 

分 类 号：R692.4[医药卫生—泌尿科学]