肾窦内肾盂加肾后下肾实质切开治疗巨大鹿角形肾结石

目的: 探讨肾窦内肾盂加肾后下肾实质切开手术治疗巨大鹿角形肾结石的疗效。方法: 采用肾窦内肾盂加肾后下肾实质切开取石术治疗巨大鹿角形肾结石43例。结果: 43例均取石成功。取出结石最大为6.6 cm×4.3 cm×3.0 cm,最多1例结石1 280枚。平均手术时间112 min,术中不需阻断肾蒂,平均术中出血260 ml。18例术后3~6个月复查尿路平片加静脉肾盂造影(KUB+IVP)或B超,4例有肾内残余结石,直径均<0.7 cm。结论: 肾窦内肾盂加肾后下肾实质切开取石术治疗巨大鹿角形肾结石术术中出血少,肾功能损害轻,操作简便、安全、易掌握、易于取净结石,是治疗巨大鹿角形肾结石较理想的手术方法之一。

Incision of the intrarenal sinus and segmental of a postrenal pole for removing of huge staghorn calculi

Objective: To explore the incision of the intrarenal sinus and segmental of a postrenal pole for removing of huge staghorn calculi.Methods: The data of 43 patients undergoing the incision of the intrarenal sinus and the segmental incision of a postrenal lower pole for the removal of huge staghorn calculi were studied.Results: The lithotomy was successful in all patients with the average operation time 112 minutes.The biggest stone was 6.6 cm×4.3 cm×3.0 cm.There were 1 280 stones in one patient.The average intraoperative bleeding volume was 260 ml.The examination 3 up to 6 months after the operation in 18 patients with kindey ureter bladder and intravenous pyelography or B ultrasound revealed residual stones in 4 patients with the diameters of less than 0.7 cm.Conclusions: The procedure needs no interruption of renal pedicle and has the advantages such as the simple operation,less bleeding,complete removal of calculus,and preservation of renal function.