CAJ | 학술논문

目的探讨腹腔镜肾盂切开联合肾镜取石术治疗肾多发性结石的技术要点和初步经验.方法选取我院2008年1月至2009年12月腹腔镜肾盂切开合并肾镜取石术治疗肾多发性结石患者8例.全部经腹膜后途径入路.结石最大3.3 cm×2.3 cm,最小0.5 cm×0.5 cm.均为肾盂铸型结石合并肾盏多发小结石.先用腹腔镜取出肾盂结石.若是铸型结石取出较难,则通过肾盂切开处放入肾镜,弹道碎石器击碎结石后再取出.然后肾镜继续探查各肾盏,并取出结石.结果 8例肾多发结石患者结石全部取尽,手术效果满意.手术时间平均90 min.均未出现出血、尿漏、输尿管狭窄等严重并发症.术后平均住院时间5 d.结论腹腔镜肾盂切开联合肾镜取石术取两种手术的优点,减少并发症的发生,可获得最大的疗效.
목적 탐토복강경신우절개연합신경취석술치료신다발성결석적기술요점화초보경험.방법 선취아원2008년1월지2009년12월복강경신우절개합병신경취석술치료신다발성결석환자8례.전부경복막후도경입로.결석최대3.3 cm×2.3 cm,최소0.5 cm×0.5 cm.균위신우주형결석합병신잔다발소결석.선용복강경취출신우결석.약시주형결석취출교난,칙통과신우절개처방입신경,탄도쇄석기격쇄결석후재취출.연후신경계속탐사각신잔,병취출결석.결과 8례신다발결석환자결석전부취진,수술효과만의.수술시간평균90 min.균미출현출혈、뇨루、수뇨관협착등엄중병발증.술후평균주원시간5 d.결론 복강경신우절개연합신경취석술취량충수술적우점,감소병발증적발생,가획득최대적료효.
Objective To study the key points and preliminary experience in the application of laparoscopic pelvilithotomy combined with percutaneous nephrolithotomy(PCNL)surgery in multiple renal calculi. Methods Eight patients,accepted laparoscopic pelvilithotomy combined with PCNL surgery in our hospital from January 2008to December 2009,were enrolled into the study. Retroperitoneal approach were performed in all operations. The biggest stone was 3.3 cm ×2.3 cm,the smallest one was 0.5 cm ×0.5 cm. All patients had renal pelvis cast stone along with multiple small renal calyceal stones. The stones were removed under laparoscopic operation at the first step. If it was difficult to remove the pelvis cast stone,nephroscope were settled into the pelvis through incision,and then the shattered stone smashed by lithotripsy were removed under the observation of nephroscope. Further exploration and removal of the remaining stones in every calices was necessary for the patients. Results The operations were successful in all cases and all stones were removed thoroughly and get satisfactory effects. The average operation time was 90 minutes. No serious complications happened,such as bleeding,urine leakage or ureteral stricture. The average length of hospital stay was 5 days. Conclusions Our treatment combines the advantages of both laparoscopic pelvilithotomy and percutaneous nephrolithotomy to reduce the incidence of complications and improve the therapeutic effects.