Viola Domenico, Anagnostou Theodore, Thompson Trevor J, Smith Gordon, Moussa Sami A, Tolley David A
The Scottish Lithotriptor Centre, Western General Hospital, Edinburgh, UK.
Urol Int. 2007;78(3):214-8. doi: 10.1159/000099340.
Horseshoe kidney is the commonest congenital renal fusion anomaly, and is often complicated by urolithiasis. We focus on our 16 years of experience with stone management in horseshoe kidneys.
We reviewed the progress of 44 patients treated between 1987 and 2002. Shock wave lithotripsy (SWL) was used in 25 patients; the average stone surface area was 91 (range 10-1,600) mm2 and average follow-up was 36.5 (range 1-91) months. 19 patients underwent percutaneous nephrolithotomy (PCNL); the average stone surface area was 197 (range 6-2,400) mm2. Follow-up data are available for 8 patients and the average follow-up was 42.3 (range 3-144) months.
In the SWL group the 3-month stone-free rate (SFR) was only 31%. In the PCNL group the SFR was 75% on the postoperative day-1 KUB. Complications occurred in 9 patients.
Stone management in horseshoe kidneys is challenging: PCNL produces a higher SFR with minimal major complications and failed access. PCNL thus appears to be the preferred management option in patients with urolithiasis in horseshoe kidneys.
马蹄肾是最常见的先天性肾融合异常，常并发尿路结石。我们重点介绍16年来马蹄肾结石治疗的经验。
回顾了1987年至2002年期间接受治疗的44例患者的治疗过程。25例患者采用冲击波碎石术（SWL）；平均结石表面积为91（范围10 - 1600）mm²，平均随访时间为第36.5（范围1 - 91）个月。19例患者接受经皮肾镜取石术（PCNL）；平均结石表面积为197（范围6 - 2400）mm²。8例患者有随访数据，平均随访时间为42.3（范围3 - 144）个月。
在SWL组中，3个月无石率（SFR）仅为31%。在PCNL组中，术后第1天KUB显示SFR为75%。9例患者出现并发症。
马蹄肾结石的治疗具有挑战性：PCNL能产生更高的SFR，且主要并发症和穿刺失败率最低。因此，PCNL似乎是马蹄肾尿路结石患者的首选治疗方法。
