微创经皮肾镜碎石取石术治疗肾结石行开放手术取石术后残留结石及复发性结石

目的探讨微创经皮肾镜碎石取石术（minimally invasive percutaneous nephrolithotomy,MPCNL）治疗肾结石行开放手术取石术后残留结石及复发性结石的临床疗效和安全性。方法对36例行开放手术取石术后残留结石及复发性结石患者采用MPCNL治疗。观察36例患者结石取净率、手术时间、术中出血量、术后肾造瘘管拔除时间以及术后住院时间等情况。结果 36例患者中采用单通道碎石取石30例,双通道碎石取石6例;结石取净率为86.1%。平均手术时间141min,平均术中出血量172mL,平均肾造瘘管拔除时间5.3d,术后住院时间6.4d。术中、术后均未出现大出血或感染性休克等严重并发症。结论 MPCNL是一种治疗肾结石行开放手术取石术后残留结石及复发性结石的有效而安全的手术方式,可作为此类结石治疗的首选方法。

Minimally Invasive Percutaneous Nephrolithotomy for Residual and Recurrent Calculi in Renal Stone Patients Previously Treated with Open Surgery

Objective To explore the clinical curative effect and safety of minimally invasive percutaneous nephrolithotomy（MPCNL）for residual and recurrent calculi in renal stone patients previously treated with open surgical procedures.Methods Thirty-six patients with residual or recurrent renal stones after open surgery were treated with MPCNL.The stone clearance rate,operative time,intraoperative blood loss,postoperative nephrostomy tube removal time and postoperative length of stay were observed.Results Of 36 patients,single-channel MPCNL was used in 30 and dual-channel in 6.The stone-free rate was 86.1%,the average operation time was 141 minutes,the average intraoperative blood loss was 172mL,the average time for removal of nephrostomy fistula was 5.3 days,and postoperative length of stay was 6.4 days.No obvious hemorrhea and septic shock and other serious complications happened.Conclusion MPCNL is an effective and safe surgical modality,and can be used as the preferred method for the treatment of residual or recurrent calculi in renal stone patients previously treated with open surgical procedures.