膀胱软镜辅助下腹腔镜肾盂切开取石术治疗复杂性肾结石的疗效及其安全性评价

doi:10.13481/j.1671-587x.20160627

Abstract

Abstract:

Objective: To compare the curative effects of laparoscopic pyelolithotomy combined with flexible cystoscopy (LPLFC) and percutaneous nephrolithotomy (PCNL) in treatment of complex renal calculi, and to evaluate its safety.Methods: A total of 62 patients with complex renal calculi were randomly divided into LPLFC group (n=31,treated with LPLFC) and PCNL group(n=31,treated with PCNL). The operative time, the hospitalization time,the decreased values of postoperative hemoglobin,occurrence of complications and one-stage stone clearance rates of the patients in two groups were compared.Results: All the operations were finished successfully.A total of 8 patients in LPLFC group complicated with homolateral adrenal or renal diseases received synchronic laparosopic surgery. The operative time and the decreased value of postoperative hemoglobin of the patients in LPLFC group were significantly shorter and lower than those in PCNL group(t=18.3,P<0.01;t=33.2,P<0.01). A total of 5 patients(16.1%) in PCNL group required transfusion postopratively because of blood loss. The hopitaliztion time and one-stage stone clearance rate of the patients in two groups had no significant differences (t=21.2,P=0.7;t=21.9,P=0.71).Conclusion: LPLFC is a minimally invasive operation method with less blood loss, shorter operative time and higher operative safety in treatment of complex renal calculi.

Key words: renal calculus, laparoscopic pyelolithotomy, percutaneous nephrolithotomy, flexible cystoscopy

CLC Number:

R692.4

ZHANG Hao, HU Cheng, HUANG Zifan, HUANG Wentao, GAO Xin, SITU Jie. Curative effect of laparoscopic pyelolithotomy combined with flexible cystoscope in treatment of complex renal calculi and its safety evaluation[J].Journal of Jilin University Medicine Edition, 2016, 42(06): 1189-1193.

References

[1] Ghani KR, Andonian S, Bultitude M, et al. Percutaneous nephrolithotomy:update, trends, and future directions[J]. Eur Urol, 2016,70(2):382-396.
[2] 徐宏伟,金承俊,阎俊,等. 经皮肾镜取石术的研究现状及并发症防治策略[J].临床泌尿外科杂志,2016,29(2):174-181.
[3] Al-Hunayan A, Khalil M, Hassabo M,et al. Management of solitary renal pelvic stone:laparoscopic retroperitoneal pyelolithotomy versus percutaneous nephrolithotomy[J]. J Endourol, 2011,25(6):975-978.
[4] Nambirajan T, Jeschke S, Albqami N,et al. Role of laparoscopy in management of renal stones:single-center experience and review of literature[J]. J Endourol, 2005,19(3):353-359.
[5] 那彦群,叶章群,孙颖浩,等.尿石症诊断治疗指南[A].中国泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社,2014:129-165.
[6] 樊胜海,周立权,黎承杨,等.经皮肾镜取石术中术后出血的风险因素分析[J].临床泌尿外科杂志,2015,30(12):1100-1104.
[7] Tefekli A, Tepeler A, Akman T, et al.The comparison of laparoscopic pyelolithotomy and percutaneous nephrolithotomy in the treatment of solitary large renal pelvic stones[J]. Urol Res, 2012, 40(5):549-555.
[8] 陈建国,陆曙炎,张焕兴,等. 腹腔镜经腹膜后途径肾盂输尿管切开取石术[J].中华泌尿外科杂志,1996(11):660-662.
[9] 袁利荣,张大宏,阮磊,等. 腹腔镜下肾窦内肾盂切开取石术疗效分析[J].中华泌尿外科杂志,2006,27(7):455-457.
[10] Gandhi HR, Thomas A, Nair B, et al. Laparoscopic pyelolithotomy:An emerging tool for complex staghorn nephrolithiasis in high-risk patients[J]. Arab J Urol,2015,13(2):139-145.
[11] Wang X, Li S, Liu T, et al. Laparoscopic pyelolithotomy compared to percutaneous nephrolithotomy as surgical management for large renal pelvic calculi:a meta-analysis[J]. J Urol, 2013, 190(3):888-893.
[12] Meria P, Milcent S, Desgrandchamps F,et al. Management of pelvic stones larger than 20 mm:laparoscopic transperitoneal pyelolithotomy or percutaneous nephrolithotomy[J]. Urol Int, 2005,75(4):322-326.
[13] Tefekli A,Tepeler A,Akman T,et al. The comparison of laparoscopic pyelolithotomy and percutaneous nephrolithotomy in the treatment of solitary large renal pelvic stones[J]. Urol Res, 2012,40(5):549-555.
[14] Antonio LP, Giovanni P, Luigi S,et al. Combined laparoscopic pyelolithotomy and endoscopic pyelolithotripsy for staghorn calculi:long-term follow-up results from a case series[J]. Ther Adv Urol, 2016, 8(1):3-8.
[15] 马凯,许清泉,黄晓波,等.结石细菌培养在经皮肾镜取石术中的临床意义[J].中华医学杂志,2010,90(4):222-224.
[16] Li H, Chen Y, Liu C,et al. Construction of a three-dimensional model of renal stones:comprehensive planning for percutaneous nephrolithotomy and assistance in surgery[J]. World J Urol, 2012,30(6):359-365.
[17] Lojanapiwat B, Kitirattrakarn P. Role of preoperative and intraoperative factors in mediating infection complication following percutaneous nephrolithotomy[J]. Urol Int, 2011,86(4):448-452.
[18] 雷鸣,夏明义,李逊,等.微创经皮肾取石术胸膜损伤并发液气胸的临床处理[J].广东医学,2007,28(9):1387-1388.

Curative effect of laparoscopic pyelolithotomy combined with flexible cystoscope in treatment of complex renal calculi and its safety evaluation

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 1

Metrics

Comments

Recommended 0