Sasaki Yumiko, Kohjimoto Yasuo, Nishizawa Satoshi, Kikkawa Kazuro, Nampo Yoshihito, Matsumura Nagahide, Inagaki Takeshi, Hara Isao
The Department of Urology, Wakayama Medical University.
Hinyokika Kiyo. 2012 Feb;58(2):87-91.
A 66-year-old woman had a 22 mm right kidney stone accompanied with a horseshoe kidney. The size of this stone had been increasing gradually from 7 mm to 22 mm during the past 5 years. Although apparent pelviuretic junction stenosis could not be identified by intravenous urography, external pelvis was dilated in both kidneys. Complete excretion of fragmented stones by extracorporeal shockwave lithotripsy seemed to be difficult because impaired urinary passage from the renal pelvis to the ureter was suspected. Percutaneous nephrolithotomy was also difficult due to malrotation of the pelvic-caliceal system and possible interposition of bowel loops between kidney and abdominal wall. Therefore, we chose laparoscopic pyelolithotomy. This procedure made it possible to remove the stone completely with minimum invasiveness. We assume that laparoscopic pyelolithotomy is a safe and effective approach for renal pelvic stone in case of horseshoe kidney.
一名66岁女性患有一枚22毫米的右肾结石，同时伴有马蹄肾。在过去5年中，这块结石的大小已从7毫米逐渐增大至22毫米。尽管静脉尿路造影未发现明显的肾盂输尿管连接处狭窄，但双肾的肾盂均有扩张。由于怀疑肾盂至输尿管的尿路存在梗阻，通过体外冲击波碎石术使结石完全排出似乎很困难。由于肾盂肾盏系统旋转不良以及肾脏与腹壁之间可能存在肠袢，经皮肾镜取石术也很困难。因此，我们选择了腹腔镜肾盂切开取石术。该手术能够以最小的创伤完全取出结石。我们认为，对于马蹄肾合并肾盂结石的情况，腹腔镜肾盂切开取石术是一种安全有效的治疗方法。
