CAJ | 학술논문

目的探讨合并临床症状的肾盏憩室结石的微创治疗方法及安全性.方法合并临床症状的肾盏憩室结石患者21例.男9例,女12例.平均年龄39(22～57)岁.憩室平均直径3.7(2.5～7.0)cm,结石平均直径为2.3(0.8～3.5)cm.患者临床表现为血尿、腰痛、泌尿系感染.均经影像学检查诊断,分别采用逆行输尿管软镜碎石4例、PCNL 7例、腹腔镜下手术取石9例、腹腔镜联合PCNL取石1例.结果 21例手术顺利,无中转开放手术、穿孔、周围脏器损伤等并发症.术后1周出现医源性动静脉瘘合并迟发性出血1例,2 d后自发形成血栓治愈;结石残留但临床症状明显缓解2例.19例无残留结石随访6～12个月结石无复发.结果有效地选择适应证和建立合理治疗方案的前提下,微创外科治疗合并临床症状的肾盏憩室结石安全有效.
목적 탐토합병림상증상적신잔게실결석적미창치료방법급안전성.방법 합병림상증상적신잔게실결석환자21례.남9례,녀12례.평균년령39(22～57)세.게실평균직경3.7(2.5～7.0)cm,결석평균직경위2.3(0.8～3.5)cm.환자림상표현위혈뇨、요통、비뇨계감염.균경영상학검사진단,분별채용역행수뇨관연경쇄석4례、PCNL 7례、복강경하수술취석9례、복강경연합PCNL취석1례.결과 21례수술순리,무중전개방수술、천공、주위장기손상등병발증.술후1주출현의원성동정맥루합병지발성출혈1례,2 d후자발형성혈전치유;결석잔류단림상증상명현완해2례.19례무잔류결석수방6～12개월결석무복발.결과 유효지선택괄응증화건립합리치료방안적전제하,미창외과치료합병림상증상적신잔게실결석안전유효.
Objective To investigate the approach and safety of minimally invasive surgical procedures treating symptomatic caliceal diverticular calculi. Methods Clinical data of 21 cases with symptomatic caliceal diverticular calculi were retrospectively reviewed. Twelve females and 9 males aged 22 to 57 years old. The average diameter of caliceal diverticulum was 3.7 cm (2.5-7.0 cm) and average diameter of calculi was 2.3 cm (0.8-3.5 cm). The patients underwent flexible ureteroscopic lithotripsy, PCNL or mPCNL, laparoscopic techniques and laparoscopy-assisted transperitoneal PCNL, respectively. Four cases underwent flexible ureteroscopic lithotripsy. PCNL (2 cases) or mPCNL(5 cases)were performed in 7 cases. Nine cases underwent laparoscopic techniques. Laparoscopyassisted transperitoneal PCNL was performed in 1 case. Results The operations were performed successfully in 21 cases. No case need to transfer to open surgery during the operation and no major complications like perforation or organic injury were noted. One case with iatrogenic arteriovenous fistula of the kidney after 1 week postoperative was cured by delayed hemorrhage 2 days later, while clinical symptoms of 2 cases with residue calculi relieved. 19 cases without residue calculi were followed up for 6 to 12 month without recurrence. Conclusions After handling indication of treatment efficiently and creating advisable therapeutic decision-making, minimally invasive surgical procedures treating symptomatic caliceal diverticular calculi appears to be effective and safe.