F16单通道微创经皮肾镜联合输尿管软镜治疗复杂鹿角形肾结石

摘要

Objective To evaluate the efficacy and safety of application of F 16 single-tract minimally invasive percutaneous nephrolithotomy ( MPCNL) combined with flexible ureteroscopy for the treatment of complex renal staghorn calculi . Methods From May 2009 to September 2012, 35 patients with complex renal staghorn calculi were treated by F 16 single-tract MPCNL combined with flexible ureteroscopy in this hospital .All the patients underwent MPCNL at the first-stage, and 5-7 days afterwards a second-stage operation was performed by using flexible ureteroscopy .The fragments of stones were removed from the MPCNL tract .For patients diagnosed as having residual stones , a third-stage reoperation of MPCNL combined with flexible ureteroscopy was given . Results Twenty-one patients were stone-free after the second-stage operation , 12 patients were stone-free after the third-stage operation , and the remaining 2 patients with residual stones were given drug administration for stone removal and were clarified as stone -free within 1 month of follow-up.No serious intraoperative or postoperative complications such as hemorrhage or infectious shock occurred .Follow-up reviews for 3 -6 months in the 35 patients found no residual stones or recurrence . Conclusion F16 single-tract MPCNL combined with flexible ureteroscopy is an effect and safe procedure for complex renal staghorn calculi .%目的：探讨F16单通道微创经皮肾镜取石术（ minimally invasive percutaneous nephrolithotomy ，MPCNL）联合输尿管软镜治疗复杂鹿角形肾结石的临床疗效和安全性。方法我院2009年5月～2012年9月对35例复杂鹿角形肾结石一期行F16单通道微创经皮肾镜取石术，术后5～7 d行二期MPCNL联合输尿管软镜碎石术，结石粉碎后由一期通道冲出，术后KUB提示结石仍有残余者3～5 d后行三期MPCNL联合输尿管软镜碎石术。结果21例二期输尿管镜碎石后结石完全清除，12例三期MPCNL联合输尿管软镜碎石后结石完全清除，2例少量残余结石给予药物排石，术后1个月随访结石排出。均无大出血、感染性休克等严重并发症。35例术后3～6个月随访，均无结石残留或复发。结论单通道MPCNL联合输尿管软镜是处理复杂鹿角形结石的一种安全有效的方法。