Clinical analysis of visible precise puncture combined with PCNL for the treatment of renal calculi without hydronephrosis: Report of 39 cases
ZHAO Guicheng1, KE Changxing1, HE Xingcheng1, ZHANG Yi1, MA Xingyong2, JIANG Changyi3, GONG Niandong4
1Department of Urology,the Second Affiliated Hospital of Kunming Medical University, Yunnan Institute of Urology,Kunming 650101, China; 2Department of Urology, the First People's Hospital of Kunming; 3Department of Urology, the First People's Hospital of Longquanyi District of Chengdu; 4Department of Urology, the First People's Hospital of Yichang
Abstract：Objective： To investigate the clinical efficacy and safety of visible precise puncture combined with PCNL in the treatment of renal calculi without hydronephrosis. Methods： A retrospective analysis was performed on 39 cases of renal calculi without hydronephrosis from August 2016 to May 2018, who underwent micro-channel or mini-channel or multi-channel of micro and mini lithotripsy combined with PCNL visible precise puncture holmium laser lithotripsy. Results： The visible precise puncture was established successfully in all 39 cases, the mean establishing time of F4.8 micro-channel and F18 mini-channel by visible puncture was （3.6±0.4） and （7.9±1.0） min respectively, the mean lithotripsy time was （46.4±19.6） min, the mean operating time was （72.4±13.8） min, the mean postoperative hospital stay was （4.9±1.2） days, the first clearance rate was 94.9% （37/39）, and no massive haemorrhage, pleural injury, intestinal injury, sepsis, or other serious complications occurred. Conclusions： The visible precise puncture combined with PCNL for the treatment of renal calculi without hydronephrosis possesses the advantages of precise puncturing, less damage, low complication incidence, with high fruiting rate and outstanding curative effects, which can be popularized in clinical practice.
赵贵成, 柯昌兴, 何星成, 张怡, 马兴永, 蒋昌毅, 龚年东. 可视穿刺式经皮肾镜碎石术治疗无积水肾结石的疗效分析（附39例报告）[J]. 微创泌尿外科杂志, 2020, 9(5): 316-320.
ZHAO Guicheng, KE Changxing, HE Xingcheng, ZHANG Yi, MA Xingyong, JIANG Changyi, GONG Niandong. Clinical analysis of visible precise puncture combined with PCNL for the treatment of renal calculi without hydronephrosis: Report of 39 cases. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(5): 316-320.
[1] 那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南.北京:人民卫生出版社,2013:169-173.
[2] KANG SK, CHO KS, KANG DH, et al.Systematic review and meta-analysis to compare success rates of retrograde intrarenal surgery versus percutaneous nephrolithotomy for renal stones >2cm: An update. Medicine (Baltimore), 2017,96(49):e9119-e9119.
[3] 李攀,李炯明,冯伟.穿刺技术在经皮肾镜取石术通道建立中的现况.临床泌尿外科杂志,2015,30(3):277-279.
[4] DESAI MR, SHARMA R, MISHRA S, et al.Single-step percutaneous nephrolithotomy (microperc): the initial clinical report. J Urol, 2011,186(1):140-145.
[5] GANPULE AP, CHABRA J, DESAI MR."Microperc" micropercutaneous nephrolithotomy: a review of the literature. Urolithiasis, 2018,46(1):107-114.
[6] 周密,俞蔚文,何翔,等.可视穿刺联合球囊扩张PCNL治疗无积水肾结石的应用体会.临床泌尿外科杂志,2018,33(2):101-103.
[7] WANG Y, HOU Y, JIANG F, et al.Standard-tract combined with mini-tract in percutaneous nephrolithotomy for renal staghorn calculi. Urol Int, 2014,92(4):422-426.
[8] EL-NAHAS AR, ERAKY I, SHOKEIR AA, et al.Factors affecting stone-free rate and complications of percutaneous nephrolithotomy for treatment of staghorn stone. Urology, 2012,79(6):1236-1241.
[9] GÜCÜK A, KEMAHLI E, ÜYETÜRK U, et al. Routine flexible nephroscopy for percutaneous nephrolithotomy for renal stones with low density: a prospective, randomized study. J Urol, 2013,190(1):144-148.
[10] 杨伟忠,何平胜.多通道微创经皮肾镜治疗复杂性肾结石.中国微创外科杂志,2012,12(3):236-238.
[11] 席勇,吴云剑,聂明,等.逆行输尿管软镜联合可视穿刺经皮肾镜治疗复杂性肾结石的疗效分析.东南大学学报,2018,37(2):263-267.
[12] TÜRK C, PETŘÍK A, SARICA K, et al. EAU guidelines on interventional treatment for urolithiasis. Eur Urol, 2016,69(3):475-482.
[13] KIM BS.How to determine the treatment options for lower-pole renal stones. Ann Transl Med, 2016,4(16):317-317.
[14] 徐汉江,郝宗耀,曾国华.肾下盏解剖结构对输尿管软镜碎石术疗效影响的研究进展.临床泌尿外科杂志,2018,33(2):129-131.
[15] 章静,李茂林,王治国,等.超微通道可视经皮肾镜治疗肾结石的临床应用.皖南医学院学报,2017,36(6):545-548.
[16] IBRAHIM B, ABDULKADIR T, TUNA K, et al.Combined micro-and standard percutaneous nephrolithotomy for complex renal calculi. Turk J Urol, 2016,42(3):150-154.
[17] CUI Z, GAO Y, YANG W, et al.Therapeutic effects of visual standard channel combined with F4.8 visual puncture super-mini percutaneous nephrolithotomy on multiple renal calculi. Pak J Med Sci, 2018,34(1):110-114.
