Hatipoglu Namık Kemal, Tepeler Abdulkadir, Buldu Ibrahim, Atis Gokhan, Bodakci Mehmet Nuri, Sancaktutar Ahmet Ali, Silay Mesrur Selcuk, Daggulli Mansur, Istanbulluoglu Mustafa Okan, Karatag Tuna, Gurbuz Cenk, Armagan Abdullah, Caskurlu Turhan
Department of Urology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey,
Urolithiasis. 2014 Apr;42(2):159-64. doi: 10.1007/s00240-013-0631-2. Epub 2013 Dec 13.
The aim of this study was to investigate the effectiveness and reliability of the micro-percutaneous nephrolithotomy (PNL) method for the management of kidney stones. We performed a retrospective analysis of 136 patients (140 renal units) who underwent micro-PNL for renal stones between September 2011 and February 2013 in four referral hospitals in Turkey. The selection of treatment modality was primarily based on factors such as stone size and location. In this study, we analyzed patient- and procedure-related factors. The mean age of patients in this study was 28.7 ± 20.6 (1-69) years, and the mean stone size was 15.1 ± 5.15 (6-32) mm. Conversion to mini-PNL was required in 12 patients. All interventions were performed with the patient in the prone position, except for the 3-year-old patient with the pelvic kidney who was placed in the supine position. The mean hospital stay was 1.76 ± 0.65 (1-4) days, and the mean drop in the hemoglobin level was 0.87 ± 0.84 (0-4.1) mg/dL. One of our patients required transfusion. Ureteral J stent was implanted in nine (6.43 %) patients because of residual stones. Seven (6.43 %) patients complained of postoperative renal colic which was managed conservatively. Abdominal distension related to extravasation of the irrigation fluid was observed in three patients (2.19 %). There were no other postoperative complications. An overall success rate of 82.14 % was achieved. Micro-PNL can be effectively and safely used for small and moderate kidney stones resistant to shock wave lithotripsy or as an alternative to other minimally invasive treatment methods.
本研究的目的是探讨微通道经皮肾镜取石术（PNL）治疗肾结石的有效性和可靠性。我们对2011年9月至2013年2月期间在土耳其四家转诊医院接受微通道经皮肾镜取石术治疗肾结石的136例患者（140个肾单位）进行了回顾性分析。治疗方式的选择主要基于结石大小和位置等因素。在本研究中，我们分析了与患者和手术相关的因素。本研究中患者的平均年龄为28.7±20.6（1 - 69）岁，平均结石大小为15.1±5.15（6 - 32）mm。12例患者需要转为迷你经皮肾镜取石术。除1例3岁盆腔肾患者采用仰卧位外，所有手术均在患者俯卧位下进行。平均住院时间为1.76±0.65（1 - 4）天，血红蛋白水平平均下降0.87±0.84（0 - 4.1）mg/dL。我们的1例患者需要输血。9例（6.43%）患者因残留结石植入了输尿管支架。7例（6.43%）患者术后出现肾绞痛，经保守治疗。3例患者（2.19%）观察到与冲洗液外渗相关的腹胀。无其他术后并发症。总体成功率为82.14%。微通道经皮肾镜取石术可有效、安全地用于对冲击波碎石术耐药的中小肾结石，或作为其他微创治疗方法的替代方法。
