Chander Jagdish, Suryavanshi Manav, Lal Pawan, Singh Lakvinder, Ramteke V K
Maulana Azad Medical College and Association, Lok Nayak Hospital, New Delhi, India.
JSLS. 2005 Jan-Mar;9(1):97-101.
We evaluated the role of retroperitoneoscopic pyelolithotomy in the management of renal calculi.
Fifty-six cases (male, 27; female, 29) of solitary or multiple renal calculi were evaluated in the study. There were 46 patients with a single calculus, 4 patients with a staghorn calculus, and 6 with a caliceal calculus. Retroperitoneoscopic pyelolithotomy was carried out after creating a retroperitoneal space with the balloon dissection method. Pneumoretroperitoneum was maintained by carbon dioxide insufflation.
Stone clearance was achieved in all cases barring 2 cases of caliceal calculi that were converted to the open procedure. The postoperative hospital stay averaged 4 days. Patients were ambulatory within 24 hours and back to work within 7 days on average. Complications encountered were peritoneal rent, subcutaneous emphysema, and superficial wound infection. The postoperative analgesic requirement averaged 100 mg of diclofenac (2 tablets).
Retroperitoneoscopic pyelolithotomy is a safe, simple, and effective minimally invasive procedure and is a feasible option that can be recommended for management of renal calculi.
我们评估了后腹腔镜肾盂切开取石术在肾结石治疗中的作用。
本研究评估了56例(男性27例,女性29例)单发或多发肾结石患者。其中46例为单个结石患者,4例为鹿角形结石患者,6例为肾盏结石患者。采用球囊扩张法建立后腹膜腔后行后腹腔镜肾盂切开取石术。通过二氧化碳气腹维持后腹膜腔充气。
除2例肾盏结石转为开放手术外,所有病例结石均清除。术后平均住院时间为4天。患者术后24小时内可下床活动,平均7天内可恢复工作。术中出现的并发症有腹膜破裂、皮下气肿和浅表伤口感染。术后平均镇痛需求量为100毫克双氯芬酸(2片)。
后腹腔镜肾盂切开取石术是一种安全、简单、有效的微创手术,是治疗肾结石的一种可行选择,值得推荐。