Associate Professor, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Tungphyatai, Rajathevee, Bangkok 10400, Thailand.
Ther Adv Urol. 2011 Feb;3(1):13-8. doi: 10.1177/1756287211398254.
To date, most cases of renal calculi have been managed with extracorporeal shockwave lithotripsy and endoscopic procedures. However, for complex renal stone conditions, these minimally invasive procedures may require multiple operative sessions. Open surgery is usually reserved as a salvage procedure, although it is invasive in nature. Laparoscopic treatment is well accepted in renal surgery. For stone disease, it can duplicate open surgical techniques such as pyelolithotomy, pyeloplasty, anatrophic nephrolithotomy, caliceal diverticulectomy and nephrectomy. Although the laparoscopic techniques for stone treatment are quite challenging, it is both feasible and safe. Laparoscopic treatment is a viable option for large renal stone treatment with an excellent stone-free rate, especially when patients require their stones to be treated within a single session. However, it is more invasive in nature than endourology procedures and so should be reserved as the last resort option for renal stone management in the modern endourology era.
迄今为止，大多数肾结石病例都是通过体外冲击波碎石术和内镜手术来治疗的。然而，对于复杂的肾结石情况，这些微创程序可能需要多次手术。开放性手术通常作为挽救性手术保留，尽管它具有侵袭性。腹腔镜治疗在肾脏手术中被广泛接受。对于结石病，它可以复制开放手术技术，如肾盂切开取石术、肾盂成形术、解剖性肾切开取石术、肾盂憩室切除术和肾切除术。虽然治疗结石的腹腔镜技术具有相当大的挑战性，但它既可行又安全。对于大肾结石的治疗，腹腔镜治疗是一种可行的选择，结石清除率很高，尤其是当患者需要在一次治疗中处理结石时。然而，与腔内泌尿外科手术相比，它的侵袭性更强，因此应该作为现代腔内泌尿外科时代肾结石管理的最后选择保留。
