Oğuz Ural, Balci Melih, Atis Gokhan, Bozkurt Omer Faruk, Tuncel Altug, Halis Fikret, Aslan Yilmaz, Yildirim Ismail Okan, Senocak Cagri, Yordam Mustafa, Atan Ali, Caskurlu Turhan, Unsal Ali
Department of Urology, Kecioren Training and Research Hospital, Ankara, Turkey,
Urolithiasis. 2014 Apr;42(2):141-7. doi: 10.1007/s00240-013-0625-0. Epub 2013 Nov 20.
The purpose of the study was to investigate feasibility of retrograde intrarenal surgery (RIRS) in patients with isolated anomaly of kidney rotation with kidney stones. We retrospectively reviewed the medical records of patients who underwent RIRS due to kidney stones in three referral hospitals. Twenty-four patients who had kidney rotation were included in this study. The patients with horseshoe kidney or pelvic kidney were not included in the study. The patients were evaluated for final success 1 month after surgery. Success was defined as stone-free or fragment smaller than 3 mm. Mean age of patients was 39.5 years (1-71 years) and male/female ratio was 3:1. Mean stone size was 13.46 mm (5-30 mm). Twelve (50 %) patients had the operation on the right side and other 12 (50 %) patients had on the left side. Eighteen (75 %) patients were stone-free after single procedure. And stone-free rate increased to 83.3 % after additional treatment procedures. When we compared the successful and failed procedures, gender, stone side and size, preoperative hydronephrosis, access sheet usage, ureteral double-J stent insertion were not statistically significant in two groups. We did not confront major complication. RIRS seems to be an effective and safe treatment option for renal stones in patients with isolated anomaly of kidney rotation.
本研究的目的是探讨逆行性肾内手术(RIRS)在孤立性肾旋转异常合并肾结石患者中的可行性。我们回顾性分析了三家转诊医院中因肾结石接受RIRS治疗的患者的病历。本研究纳入了24例存在肾旋转的患者。马蹄肾或盆腔肾患者未纳入本研究。术后1个月对患者进行最终成功评估。成功定义为结石清除或结石碎片小于3mm。患者的平均年龄为39.5岁(1 - 71岁),男女比例为3:1。平均结石大小为13.46mm(5 - 30mm)。12例(50%)患者在右侧进行手术,另外12例(50%)患者在左侧进行手术。18例(75%)患者单次手术后结石清除。经过额外治疗后,结石清除率提高到83.3%。当我们比较成功和失败的手术时,两组在性别、结石部位和大小、术前肾积水、通道片使用、输尿管双J支架置入方面无统计学差异。我们未遇到重大并发症。RIRS似乎是孤立性肾旋转异常患者肾结石的一种有效且安全的治疗选择。