重复肾输尿管畸形合并上尿路结石的腔内外科治疗体会

摘要

目的 探讨重复肾输尿管畸形合并上尿路结石的腔内外科治疗方法和效果.方法 回顾性分析26例腔内外科治疗的重复肾输尿管畸形合并上尿路结石患者的临床资料.结果 应用输尿管硬镜碎石取石术(URL)治疗5例,输尿管软镜钬激光碎石术(RIRS)治疗15例,微创经皮肾镜碎石取石术(mPCNL)治疗6例.所有患者均成功完成手术,无感染性休克、大出血、输尿管损伤和气胸等严重并发症.23例获得随访的患者,随访2~24个月,未出现输尿管狭窄病变,肾积水均有不同程度的减轻.结论 腔内外科技术治疗重复肾输尿管畸形合并上尿路结石具有创伤小、恢复快和安全性高等优点.%Objective To investigate the intracavitary surgical therapy and efficacy for the patients with duplex kidney and ureter with upper urinary tract calculi. Methods The clinical data of twenty-six cases with duplex kidney and ureter with upper urinary tract calculi were retrospectively analyzed. Results Of 26 patients who underwent intracavitary surgical treatment, 5 patients were treated by ureteroscopic lithotripsy (URL), 15 by retrograde intrarenal surgery (RIRS), 6 by mini-percutaneous nephrolithotomy (mPCNL). All 26 cases were performed successfully. No severe complications such as septic shock, heavy blood loss, ureter injury, and pneumothorax occurred. 23 patients with nephrohydrosis were followed up for 2 to 24 months and most of them improved at different extents. Conclusion The current technique of intracavitary surgery in the management of duplex kidney and ureter concomitant with upper urinary tract calculi, has the advantages of less trauma, rapid recovery, safety and so on.