Tazi K, Karmouni T, Janane A, el Fassi M J, Koutani A, Ibn Attya A, Hachimi M, Lakrissa A
Service d'urologie B, hôpital Ibn-Sina, Rabat, Maroc.
Ann Urol (Paris). 2000 Dec;34(6):365-9.
We retrospectively investigated 63 patients suffering from 71 staghorn calculi, who were treated with primary surgical monotherapy, in order to determine long-term. results and the fate of the residual stones.
Mean follow-up was 2.6 years. There were 63 patients (32 men, 31 women). The treatment was pyelolithotomy alone in 26 cases; nephrolithotomy alone in 14 cases; pyelolithotomy associated with nephrolithotomy in 18 cases; percutaneous nephrolithotomy (PCNL) in two cases; extracorporeal shock-wave lithotripsy (ESWL) in one case; and nephrectomy in ten cases.
At the conclusion of therapy the stone-free rate was 94.1%. The complication was septic complications in 12 patients, hemorrhage that needed transfusion in five case and fistula in one case. After four and six years, two patients developed renal insufficiency and two patients had a recurrence of stones.
Primary surgery of complex staghorn calculi is justified because of its better results than PCNL associated with ESMIL.
我们回顾性研究了63例患有71枚鹿角形结石的患者，这些患者接受了一期手术单一疗法治疗，以确定长期结果及残余结石的转归。
平均随访时间为2.6年。患者共63例（男性32例，女性31例）。治疗方法为：单纯肾盂切开取石术26例；单纯肾切开取石术14例；肾盂切开取石术联合肾切开取石术18例；经皮肾镜取石术（PCNL）2例；体外冲击波碎石术（ESWL）1例；肾切除术10例。
治疗结束时结石清除率为94.1%。并发症包括12例患者发生感染性并发症，5例患者出血需要输血，1例患者发生瘘管。4年和6年后，2例患者出现肾功能不全，2例患者结石复发。
复杂性鹿角形结石的一期手术是合理的，因为其效果优于PCNL联合ESWL。
