CAJ | 학술논문

目的探讨肾盏憩室合并结石、感染的诊治特点及方法.方法肾盏憩室患者29例.男11例,女18例.平均年龄26(18～61)岁.其中单纯性肾盏憩室3例,合并感染14例(其中3例外院以肾囊肿行去顶减压术后漏尿转入),合并结石12例.行开放手术治疗10例,憩室去顶,并缝合憩室开口;行腹腔镜下手术8例,憩室处理同开放手术,2例合并结石者同时行取石术;行经皮肾镜取石术(PCNL)11例,取出结石并扩张憩室盏颈,留置肾造瘘管,其中1例中转开放.结果开放及腹腔镜下手术均取得成功,腹腔镜术后1例漏尿予患侧放置双J管1个月后治愈;1例行PCNL术失败中转开放.取石术后1周复查KUB平片无结石残留.29例平均随访14(6～24)个月,患者症状明显改善,无再发感染及结石.结论肾盏憩室常合并结石及感染,采用腹腔镜及PCNL等手术治疗安全可行,疗效确切.术前确诊、术前准备及术中证实是确保手术成功的重要环节.
목적 탐토신잔게실합병결석、감염적진치특점급방법.방법신잔게실환자29례.남11례,녀18례.평균년령26(18～61)세.기중단순성신잔게실3례,합병감염14례(기중3예외원이신낭종행거정감압술후루뇨전입),합병결석12례.행개방수술치료10례,게실거정,병봉합게실개구;행복강경하수술8례,게실처리동개방수술,2례합병결석자동시행취석술;행경피신경취석술(PCNL)11례,취출결석병확장게실잔경,류치신조루관,기중1례중전개방.결과개방급복강경하수술균취득성공,복강경술후1례루뇨여환측방치쌍J관1개월후치유;1례행PCNL술실패중전개방.취석술후1주복사KUB평편무결석잔류.29례평균수방14(6～24)개월,환자증상명현개선,무재발감염급결석.결론신잔게실상합병결석급감염,채용복강경급PCNL등수술치료안전가행,료효학절.술전학진、술전준비급술중증실시학보수술성공적중요배절.
Objective To analyze the diagnosis and treatment for complications of renal caliceal diverticulum with calculi or infection. Methods A retrospective investigation was performed on 29 cases with renal caliceal diverticulum. The 29 cases included 11 males and 18 females aged 18 to 61 years. Among the study group, 3 cases were simple renal caliceal diverticulum, 12 cases were diagnosed as diverticular calculi and 14 cases presented recurrent urinary tract infections including 3 cases with urinary fistula after unroofing and decompression as renal simple cyst from another hospital. Ten cases underwent an open operation that unroofed and decompressed the cyst, and sutured the diverticular neck. Eight cases underwent laparoscopic operation similar to the open operation, including lithotomy in caliceal diverticulum in 2 cases. Eleven cases diagnosed with caliceal diverticular calculi were taken one-stage percutaneous nephrolithotomy including dilating the diverticular neck, remaining the nephrostomy catheter and Double-J ureteral stents, and 1 case was transferred to open operation.Results The open and laparoscopic operations were performed successfully. One case was cured by Double-J ureteral stenting after postoperative urinary leakage. One case was transferred to open operation for the failure of percutaneous puncturation. X-ray examination revealed that there were no remaining stones after the operation. All the patients were followed up for 6 to 24 months without calculi and infection recurrence. Conclusions Stones and infection are common that complications of renal caliceal diverticulum. Percutaneous nephrolithotomy, laparoscopy and other operations were effective and feasible treatment options for cases with complications of renal caliceal diverticulum. Exact diagnosis was very important for treatment of renal caliceal diverticulum before operation.