CAJ | 학술논문

目的：探讨复杂性鹿角状肾结石的手术治疗经验。方法：对56例复杂性鹿角状肾结石患者行逆行尿路造影，了解结石与肾盂肾盏的解剖关系，采用体外震波碎石后肾盂切开取石，肾盂联合下盏实质切开取石，低温肾血管阻断下肾实质切开取石等不同手术方式治疗。评估术后结石残留，肾周漏尿和感染的发生率等。结果：56例手术均成功，术中平均出血量150～450mL．结石残留8例，漏尿和感染4例。结论：复杂肾结石的手术治疗较为棘手，很难用一种手术方法去解决所有的病情。了解结石与肾盏的关系，采用不同手术方式是治疗复杂性鹿角状肾结石的有效方法。
목적：탐토복잡성록각상신결석적수술치료경험。방법：대56례복잡성록각상신결석환자행역행뇨로조영，료해결석여신우신잔적해부관계，채용체외진파쇄석후신우절개취석，신우연합하잔실질절개취석，저온신혈관조단하신실질절개취석등불동수술방식치료。평고술후결석잔류，신주루뇨화감염적발생솔등。결과：56례수술균성공，술중평균출혈량150～450mL．결석잔류8례，루뇨화감염4례。결론：복잡신결석적수술치료교위극수，흔난용일충수술방법거해결소유적병정。료해결석여신잔적관계，채용불동수술방식시치료복잡성록각상신결석적유효방법。
Objective： To explore the surgical experience of complex staghorn kidney stones. Methods： Fifty six cases with complex staghorn kidney stones were conducted retrograde urography to get information of anatomic relationship between stones and renal pelvis. Three different operative methods including extracorporeal shock wave lithotomy combined pelvilithotomy, lithotomy of pelvis and in fra-ealiees renal and lithotomy under the low-temperature block renal vascular were applied. The postoperative incidence of residual stones, perirenal urine leakage and infection were evaluated. Results： All patients were successfully operated, The average intraoperative blood loss was 150-450mL. There were 8 eases of residual stones, 4 cases of perirenal urine leakage and infection were observed. The data showed there were no statistics differences among the three operative methods. Conclusions： The anatomy relation between stones and calyceal or pelvis collected and applied different open surgical methods were helpful in management of complex staghorn kidney stones.