Ziypak Tevfik, Adanur Senol, Tepeler Abdulkadir, Erdem Mehmet Remzi, Akcay Muzaffer, Armagan Abdullah, Ozbey Isa, Polat Ozkan
1 Department of Urology, Ataturk University , Erzurum, Turkey .
J Endourol. 2014 Oct;28(10):1192-6. doi: 10.1089/end.2014.0189. Epub 2014 Aug 13.
Flexible nephroscopy is an important technique in the management of staghorn renal calculi to reach peripheral calices. In this study, we present our experience with flexible nephroscopy and fluoroscopy-guided additional access creation for staghorn renal calculi.
We conducted a retrospective analysis of patients with staghorn renal calculi who were treated with multiple percutaneous renal tracts created with the guidance of flexible nephroscopy and fluoroscopy. Additional tracts were performed with combined flexible nephroscopy and fluoroscopy guidance. Flexible nephroscopy was used to help target the calix and ensure the safety of access.
Additional percutaneous renal access was achieved using combined flexible nephroscopy and fluoroscopy guidance in 26 patients with complete staghorn (n=21) and partial staghorn (n=5) kidney stones. The cumulative stone size was 59.3 mm. The mean procedure times, fluoroscopy times, and hospitalization times were 91.5 minutes, 3.4 minutes, and 2.7 days, respectively. The postoperative hematocrit drop was 4.96±3.8. Upper and lower calices were the most common primary access tracts in 11 and 15 patients, respectively. Stone-free status was achieved in 22 (84.6%) patients with a mean 2.1±0.3 tract number. Postoperative complications were observed in six (23.1%) patients.
In the requirement of additional access for staghorn renal calculi, use of flexible nephroscopy with fluoroscopy increases the safety of the procedure by confirmation of precise renal access.
软性肾镜检查是处理鹿角形肾结石以到达外周肾盏的一项重要技术。在本研究中，我们介绍了我们在软性肾镜检查及荧光透视引导下为鹿角形肾结石建立额外通道的经验。
我们对在软性肾镜检查及荧光透视引导下通过建立多个经皮肾通道治疗的鹿角形肾结石患者进行了回顾性分析。在软性肾镜检查与荧光透视联合引导下建立额外通道。使用软性肾镜检查来帮助定位肾盏并确保通道安全。
在26例完全鹿角形（n = 21）和部分鹿角形（n = 5）肾结石患者中，通过软性肾镜检查与荧光透视联合引导成功建立了额外的经皮肾通道。结石累计大小为59.3 mm。平均手术时间、透视时间和住院时间分别为91.5分钟、3.4分钟和2.7天。术后血细胞比容下降为4.96±3.8。上肾盏和下肾盏分别是11例和15例患者最常见的初始通道部位。22例（84.6%）患者实现了无结石状态，平均通道数为2.1±0.3个。6例（23.1%）患者观察到术后并发症。
在鹿角形肾结石需要建立额外通道时，使用软性肾镜检查并结合荧光透视通过确认精确的肾通道来提高手术安全性。
