Starownik Radosław, Golabek Tomasz, Bar Krzysztof, Muc Kamil, Płaza Paweł, Chlosta Piotr
Department of Urology and Urological Oncology, Medical University of Lublin, Lublin, Poland.
Department of Urology, Medical College Jagiellonian University, Krakow, Poland.
Wideochir Inne Tech Maloinwazyjne. 2014 Dec;9(4):501-4. doi: 10.5114/wiitm.2014.44168. Epub 2014 Jul 22.
Symptomatic hypermobile kidney is treated with nephropexy, a surgical procedure through which the floating kidney is fixed to the retroperitoneum. Although both open and endoscopic procedures have a high success rate, they can be associated with risk of complications, relatively long hospital stay and high cost.
We describe our percutaneous technique for fixing a hypermobile kidney and evaluate the efficacy of the percutaneous nephrostomy insertion in management of symptomatic nephroptosis.
Between January 2005 and December 2011, 11 patients diagnosed with a symptomatic right nephroptosis of at least 1 year duration were treated with a single point percutaneous nephrostomy technique. All data were retrieved from patients' medical records and then retrospectively analysed.
Nephropexy through a single point percutaneous nephrostomy technique was successfully accomplished in 11 women. The mean operative time was 20 min. The intraoperative estimated blood loss was minimal in all cases. No major or minor intraoperative complications were noted. The average postoperative hospital stay was 2 days. Women returned to their usual activities 14 days following the surgery. Nine women had complete resolution of their pain, and 2 patients continued to complain of discomfort in their lumbar area. One patient was re-operated upon with satisfactory subjective and objective outcomes achieved. One patient refused re-operation.
Percutaneous nephropexy is simple, inexpensive and effective for treatment of symptomatic hypermobile kidney. It remains a valuable alternative to open, laparoscopic, and robotic methods for fixing a floating kidney.
有症状的活动度大的肾脏采用肾固定术治疗，这是一种将浮动肾固定于腹膜后的外科手术。尽管开放手术和内镜手术成功率都很高，但它们可能伴有并发症风险、住院时间相对较长及费用高昂的问题。
我们描述经皮固定活动度大的肾脏的技术，并评估经皮肾造瘘术治疗有症状肾下垂的疗效。
2005年1月至2011年12月期间，11例诊断为有症状的右侧肾下垂且病程至少1年的患者接受了单点经皮肾造瘘术治疗。所有数据均从患者病历中获取，然后进行回顾性分析。
11例女性患者通过单点经皮肾造瘘术成功完成肾固定术。平均手术时间为20分钟。所有病例术中估计失血量极少。未发现任何术中大小并发症。术后平均住院时间为2天。女性患者术后14天恢复日常活动。9例女性患者疼痛完全缓解，2例患者仍抱怨腰部不适。1例患者接受再次手术，主观和客观结果均令人满意。1例患者拒绝再次手术。
经皮肾固定术治疗有症状的活动度大的肾脏简单、廉价且有效。它仍是开放手术、腹腔镜手术和机器人手术固定浮动肾的一种有价值的替代方法。
