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脊柱畸形患者采用软性输尿管镜进行逆行性肾内手术。

Retrograde intrarenal surgery by flexible ureteroscope in patients with spinal deformities.

作者信息

Polat Fazli, Yesil Suleyman

机构信息

a Department of Urology, Faculty of Medicine , Gazi University , Besevler , Ankara , Turkey.

出版信息

J Spinal Cord Med. 2017 Jan;40(1):26-29. doi: 10.1179/2045772315Y.0000000025. Epub 2016 Feb 23.

Abstract

OBJECTIVE

To present our experience with retrograde intrarenal surgery (RIRS) for managing renal stones in patients with spinal deformities.

DESIGN

We retrospectively reviewed the records of patients.

METHODS

We retrospectively reviewed the records of seven patients with congenital scoliosis (n = 5), spina bifida (n = 2) who had undergone RIRS for renal stones. Stone-free status was determined by CT 30 days after the procedure and was defined as the absence of stones in the kidney or residual fragments ≤1 mm.

RESULTS

Mean patient age was 27 years (18-45 years), and mean stone size was 176 mm (143-340 mm). The average operative time was 38 minutes (25-53 minutes), and postoperative hospital stay was 1 day (1-2 days). A stone-free status was obtained in six (85.7 %) patients, and one patient was considered to have treatment failure. This patient was managed by a repeat RIRS. A Double-J stent was placed at the end of the procedure in all (100 %) patients. No severe complications, either from anesthesia or the surgical procedure, were observed, and no blood transfusion was reported.

CONCLUSIONS

The good clearance rate with a low incidence of complications shown by the present study has demonstrated that RIRS is a safe and effective procedure for renal stones in patients with spinal deformities.

摘要

目的

介绍我们运用逆行性肾内手术(RIRS)治疗脊柱畸形患者肾结石的经验。

设计

我们对患者的记录进行了回顾性研究。

方法

我们回顾性分析了7例因肾结石接受RIRS治疗的先天性脊柱侧弯患者(n = 5)和脊柱裂患者(n = 2)的记录。术后30天通过CT确定结石清除状态,定义为肾脏无结石或残留碎片≤1毫米。

结果

患者平均年龄为27岁(18 - 45岁),平均结石大小为176毫米(143 - 340毫米)。平均手术时间为38分钟(25 - 53分钟),术后住院时间为1天(1 - 2天)。6例(85.7%)患者达到结石清除状态,1例患者被认为治疗失败,该患者接受了再次RIRS治疗。所有患者(100%)在手术结束时均放置了双J支架。未观察到麻醉或手术引起的严重并发症,也未报告输血情况。

结论

本研究显示出良好的清除率和较低的并发症发生率,表明RIRS是治疗脊柱畸形患者肾结石的一种安全有效的方法。

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