CAJ | 학술논문

目的比较经尿道输尿管镜取石术(URL)与微创经皮肾镜取石术(MPCNL)治疗长径≥1.5 cm输尿管上段结石的疗效.方法对58例长径≥1.5 cm的输尿管上段结石分别采用URL(URL组,35例)和MPCNL(MPCNL组,23例)治疗,比较两组疗效.术前所有患者均做超声及IVU检查.结果 URL组中13例结石被完全清除,成功率37.1%(13/35);8例结石部分返回肾盂,需结合体外冲击波碎石术(ESWL);7例因输尿管扭曲严重,3例因输尿管狭窄,4例因术野不清改行MPCNL或开放手术;平均手术时间为38min.MPCNL组中21例经一次手术清除结石,成功率91.3%(21/23);2例因患肾残留结石须行ESWL,平均手术时间为34 min.两组成功率比较,差异有统计学意义.结论相对于URL而言,MPCNL是一种治疗长径≥1.5 cm输尿管上段结石安全而有效的方法.
목적 비교경뇨도수뇨관경취석술(URL)여미창경피신경취석술(MPCNL)치료장경≥1.5 cm수뇨관상단결석적료효.방법 대58례장경≥1.5 cm적수뇨관상단결석분별채용URL(URL조,35례)화MPCNL(MPCNL조,23례)치료,비교량조료효.술전소유환자균주초성급IVU검사.결과 URL조중13례결석피완전청제,성공솔37.1%(13/35);8례결석부분반회신우,수결합체외충격파쇄석술(ESWL);7례인수뇨관뉴곡엄중,3례인수뇨관협착,4례인술야불청개행MPCNL혹개방수술;평균수술시간위38min.MPCNL조중21례경일차수술청제결석,성공솔91.3%(21/23);2례인환신잔류결석수행ESWL,평균수술시간위34 min.량조성공솔비교,차이유통계학의의.결론 상대우URL이언,MPCNL시일충치료장경≥1.5 cm수뇨관상단결석안전이유효적방법.
Objective To compare ureteroscopic hthotomy (URL)and minimally invasive percuta-neous nephrolithotomy (MPCNL) for the management of upper-ureteral calculi ≥ 1.5 cm. Methods Fifty-eight patients with upper-ureteral calculi ≥ 1.5 cm were selected in randomized for URL group (35patients)or MPCNL group (23 patients). Ultrasonography and intravenous X-ray were performed for all pa-tients before surgery. Results In the URL group, 13 cases (37.1%)were rendered stone-free, 8 stones mi-grated upward to the pelvis of kidney. In these cases,a double- J stent was inserted, and ESWL was per-formed,7 cases had ureteral distortion, 3 cases had ureteral stricture, 4 cases had bad field of vision, MPCNL or open operation was performed in these eases. The mean operative time was 38 minutes (range 25-48 min-utes). In the MPCNL group,21 eases (91.3%)were rendered stone-free. In the other 2 patients,ESWL was performed because the stone fragments migrated upward to the pelvis of kidney. The mean operative time was 34 minutes (range 20-58 minutes). Conclusion Compared with URL,MPCNL is a safe and effective procedure for treating upper-ureteral calculi ≥ 1.5 cm.