Aganović Damir, Kulovac Benjamin, Prcić Alden, Hadziosmanović Osman
Urology Clinic, University of Sarajevo Clinics Centre, Bolnicka 25, 71 000 Sarajevo, Bosnia and Herzegovina.
Bosn J Basic Med Sci. 2007 Aug;7(3):235-8. doi: 10.17305/bjbms.2007.3051.
Anatrophic nephrolithotomy (ANL) in the selected cases represents the method of choice in the treatment of staghorn calculi. We evaluated postoperative outcome of patients subjected to standard ANL that received 10 mg of Verapamil immediately before declamping renal artery, due to prevention of reperfusion injury. From 2002 to 2005, 18 nephrolithotomies were performed on 15 patients, in the Urology Clinic, University of Sarajevo Clinics Centre. Preoperative evaluation included intravenous urography and radionuclide renal scans which had been repeated 6 months after the operations. 10 males and 5 females were operated with mean age of 45 years. Urography and renal scans showed severe calyceal distortion and infundibular stenosis in 83% cases, complicated with ureteropelvic junction obstruction in 55% cases. Chronic kidney failure was present in 60% patients. Mean operative time was 150 minutes, with mean cold ischemia time of 61 minutes and mean blood loss of 300ml. There were five minor postoperative complications. Residual small calculi were found in 3 patients. Kidney function was stabilized in the patients suffering from chronic kidney failure, which was proved by radio nuclide imaging. ANL improved by using calcium channel blockers as a protective factor for reperfusion injury proved to be a good treatment choice with a low level of complications and noticeable stabilization and improvement of kidneys function.
在选定病例中，萎缩性肾切开取石术（ANL）是治疗鹿角形结石的首选方法。我们评估了接受标准ANL治疗的患者的术后结果，这些患者在松开肾动脉前立即接受了10毫克维拉帕米治疗，以预防再灌注损伤。2002年至2005年，萨拉热窝大学临床中心泌尿外科对15例患者进行了18次肾切开取石术。术前评估包括静脉肾盂造影和放射性核素肾扫描，术后6个月重复进行。手术的10名男性和5名女性，平均年龄45岁。静脉肾盂造影和肾扫描显示，83%的病例存在严重的肾盏变形和漏斗部狭窄，55%的病例合并输尿管肾盂连接处梗阻。60%的患者存在慢性肾衰竭。平均手术时间为150分钟，平均冷缺血时间为61分钟，平均失血量为300毫升。术后有5例轻微并发症。3例患者发现残留小结石。慢性肾衰竭患者的肾功能得以稳定，放射性核素成像证实了这一点。事实证明，使用钙通道阻滞剂作为再灌注损伤的保护因素来改进ANL是一种很好的治疗选择，并发症发生率低，肾功能有明显的稳定和改善。
