Abstract：Objective:To investigate the clinical effect of single-tract percutaneous nephrolithotomy (PCNL) combined with flexible ureterorenoscopy in the second stage treatment of complicated renal calculi. Methods:A retrospective review was performed on 19 patients including 12 men and 7 women and the mean age was (48.7±9.7) years. All patients underwent single-tract PCNL at the first stage. Then F20 nephrostomy tubes were placed for 1-2 weeks and a second-stage operation was performed. Results:The maximum diameter of renal calculi was 1.6-3.5 (2.5±0.6) cm. The average operation time was 41-126 (79±24) min and the overall success rate was 84.2% (16/19). The mean hospital stay postoperation was (5.2±0.9) days. There was one case of urosepsis after operation. The patient was given vigorous anti-infectious therapy and eventually recovered. The incidence of surgical complications was 5.2%. Conclusions:Single-tract PCNL combined with flexible ureterorenoscopy for complicated renal calculi has the advantages of safety, effectiveness and less surgical trauma. In addition, the clearer field of vision during the operation could be obtained at the second stage compared with that of the first stage.
王锐, 石洪波, 周吉, 曹军, 刘晓丽, 丁晨. 单通道经皮肾镜后二期联合逆行输尿管软镜治疗复杂性肾结石疗效分析[J]. 微创泌尿外科杂志, 2018, 7(2): 101-104.
Wang Rui, Shi Hongbo, Zhou Ji, Cao Jun, Liu Xiaoli, Ding Chen. Clinical effect of single-tract percutaneous nephrolithotomy and flexible ureterorenoscopy in the second stage treatment of complicated renal calculi. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2018, 7(2): 101-104.
[1] 王黎,姚启盛,王晓康,等.微创经皮肾镜取石术治疗异常肾肾结石.中国现代手术学杂志,2011,15(4):282-284. [2] Preminger GM, Assimos DG, Lingeman JE, et al.Chapter 1: AUA guideline on management of staghorn calculi: diagnosis and treatment recommendations. J Urol, 2005,173(6):1991-2000. [3] 阮东丽,张更,李智斌,等.经尿道输尿管软镜与经皮肾镜治疗单侧肾结石的比较.中华腔镜泌尿外科杂志(电子版),2015,9(3):22-25. [4] Armitage JN, Irving SO, Burgess NA, et al.Percutaneous nephrolithotomy in the United Kingdom: results of a prospective data registry. Eur Urol, 2012,61(6):1188-1193. [5] 齐勇,汤春波,周永,等.输尿管软镜取石术治疗经皮肾镜术残留肾结石12例报告.临床泌尿外科杂志,2014,29(12):1073-1074. [6] 李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36(2):124-126. [7] 徐桂彬,李逊,何朝辉,等.微创经皮肾镜取石术出血量影响因素的分析.中华泌尿外科杂志,2007,28(7):456-459. [8] Hussain M, Acher P, Penev B, et al.Redefining the limits of flexible ureterorenoscopy. J Endourol, 2011,25(1):45-49. [9] 贺飞,张晓忠,杨青山,等.输尿管软镜钬激光碎石术治疗经皮肾镜取石术术后的残留结石.中华腔镜泌尿外科杂志(电子版),2013,7(3):49-51. [10] 刘建河,潘春武,李瑞鹏,等.输尿管软镜下钬激光碎石处理直径2cm肾结石.中国微创外科杂志,2014,14(2):132-133. [11] Marguet CG, Springhart WP, Tan YH, et al.Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. BJU Int, 2005,96(7):1097-1100. [12] 李逊,徐桂彬,何永忠,等.单通道经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石疗效观察(附79例报告).临床泌尿外科杂志,2012,27(6):452-454. [13] 李瑞鹏,齐隽,刘建河.F_(16)单通道微创经皮肾镜联合输尿管软镜治疗复杂鹿角形肾结石.中国微创外科杂志,2015,15(2):115-117. [14] 徐刚,虞力航,周毅.单通道经皮肾镜联合输尿管软镜碎石术治疗复杂性肾结石的临床研究.中国内镜杂志,2016,22(5):107-109. [15] 黄向江,郭吉楠,张轶庠,等.Ⅱ期经皮肾镜碎石联合逆行输尿管软镜治疗PCNL术后残余结石.微创泌尿外科杂志,2016,5(6):343-346.
