CAJ | 학술논문

目的探讨逆行肾内手术(Retrograde Intra-Renal Surgery,RIRS)治疗马蹄肾肾结石的临床疗效.方法回顾性分析2008年8月至2013年8月采用RIRS治疗11例马蹄肾肾结石患者,其中9例为肾结石,直接用输尿管软镜碎石;2例为输尿管上段结石,先用输尿管硬镜碎石,碎石过程中结石移至肾脏,后改用软镜碎石.分析其平均手术时间、平均住院天数、清石率和并发症,术后1个月作CT和KUB检查评估结石清除率(stone-free rate,SFR).结果 11例患者结石大小为(1.5±0.3)cm,手术平均时间为(72.3±22.6) min,平均住院天数(5.2±1.8)d,术后1个月SFR为81.8％.2例二期行输尿管软镜碎石,二期SFR为100％;其中1例术后出现发热,1例术后出现腰痛,对症治疗后能缓解;所有患者无输尿管穿孔及狭窄,无肾功能衰竭等严重并发症.结论对于＜ 2cm的马蹄肾肾结石,RIRS具有创伤小,住院时间短,并发症少,SFR高等优点,值得推广.
목적 탐토역행신내수술(Retrograde Intra-Renal Surgery,RIRS)치료마제신신결석적림상료효.방법 회고성분석2008년8월지2013년8월채용RIRS치료11례마제신신결석환자,기중9례위신결석,직접용수뇨관연경쇄석;2례위수뇨관상단결석,선용수뇨관경경쇄석,쇄석과정중결석이지신장,후개용연경쇄석.분석기평균수술시간、평균주원천수、청석솔화병발증,술후1개월작CT화KUB검사평고결석청제솔(stone-free rate,SFR).결과 11례환자결석대소위(1.5±0.3)cm,수술평균시간위(72.3±22.6) min,평균주원천수(5.2±1.8)d,술후1개월SFR위81.8％.2례이기행수뇨관연경쇄석,이기SFR위100％;기중1례술후출현발열,1례술후출현요통,대증치료후능완해;소유환자무수뇨관천공급협착,무신공능쇠갈등엄중병발증.결론 대우＜ 2cm적마제신신결석,RIRS구유창상소,주원시간단,병발증소,SFR고등우점,치득추엄.
Objectives To evaluate the safety and efficacy of retrograde intra-renal surgery (RIRS) in treating renal stones of ＜ 2cm in the horseshoe kidney.Methods We retrospectively reviewed 11 patients from August 2008 to August 2013,who underwent RIRS due to renal stones of ＜ 2cm in the horseshoe kidney.In all,9 patients with renal stones were treated with flexible ureteroscope directly.2 patient with upper ureteral calculi were treated with rigid ureteroscope first,and the stone moved to the kidney during the operation.Then the flexible ureteroscope was used.Mean operation time,hospitalization days,stone-free rate(SFR) and complications were recorded and analyzed.Results The stone burden of 11 patients was (1.5 ± 0.3) cm.The mean operation time was (72.3 ± 22.6) min.The hospitalization days was (5.2 ± 1.8) cm.The operations with 9 patients were The SFR was 81.8％ one month after operation.Two patients underwent second flexible ureteroscope and the SFR was 100％.Of all,postoperative fever was in one patient and backache was in one patient,which could be alleviated after symptomatic treatment.No patients had serious complications.Conclusions RIRS was a safe and efficacy treatment for renal stones of ＜2cm in the horseshoe kidney.