Singh Vishwajeet, Sinha Rahul Janak, Gupta Dheeraj Kumar
Department of Urology, King George Medical University, Lucknow, Uttar Pradesh, India.
Curr Urol. 2013 Aug;7(1):7-13. doi: 10.1159/000343545. Epub 2013 Jul 28.
Nephrolithiasis has been reported in 20-28% of patients, of whom 50% are symptomatic for stone disease and 20% require definite urologic intervention. The management of nephrolithiasis includes oral alkali dissolution therapy, extracorporeal shock wave lithotripsy and surgical treatment. In such patients, percutaneous nephrolithotomy (PNL) as a method of stone treatment has been reported in few cases with limited experience. The aim of this study is to present our experience of PNL in autosomal dominant polycystic kidney disease (ADPKD) and assessing the outcome results.
From 2002 to 2011, 22 patients (26 renal units) suffering from ADPKD with stone were managed by PNL. Demographic characteristics, operative parameters and postoperative complications were recorded and analysed.
The overall success rate of PNL was 82.1% and PNL with extracorporeal shock wave lithotripsy for clinically significant residual fragments was 92.85% respectively. The hematuria required blood transfusion (n = 9), postoperative fever due to cyst infection (n = 4) and paralytic ileus (n = 3) were recorded.
The PNL in ADPKD PNL is safe and effective but have more postoperative complications such as bleeding requiring transfusions, fever due to cyst infection and paralytic ileus.
据报道，20% - 28%的患者患有肾结石，其中50%有结石病症状，20%需要明确的泌尿外科干预。肾结石的治疗方法包括口服碱化溶解疗法、体外冲击波碎石术和手术治疗。在这类患者中，经皮肾镜取石术（PNL）作为一种结石治疗方法，仅有少数病例报道，经验有限。本研究的目的是介绍我们在常染色体显性多囊肾病（ADPKD）患者中应用PNL的经验并评估其结果。
2002年至2011年，对22例（26个肾单位）患有ADPKD并伴有结石的患者实施了PNL治疗。记录并分析患者的人口统计学特征、手术参数及术后并发症。
PNL的总体成功率为82.1%，联合体外冲击波碎石术治疗具有临床意义的残留结石碎片的成功率为92.85%。记录到有9例血尿需要输血，4例因囊肿感染出现术后发热，3例出现麻痹性肠梗阻。
ADPKD患者行PNL是安全有效的，但术后并发症较多，如出血需输血、囊肿感染发热及麻痹性肠梗阻。
