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慢性肾病合并盆腔异位肾患者的腹腔镜辅助经皮肾镜取石术

Laparoscopic assisted percutaneous nephrolithotomy in chronic kidney disease patients with ectopic pelvic kidney.

作者信息

Patwardhan Sujata K, Shelke Umesh Ravikant, Patil Bhushan P, Pamecha Yash R

机构信息

Department of Urology, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India.

出版信息

Urol Ann. 2017 Jul-Sep;9(3):257-260. doi: 10.4103/UA.UA_16_17.

Abstract

PURPOSE

Patients with deranged renal functions have a number of associated factors which can impair healing of wound and increase postoperative morbidity. This study was conducted to assess the problems while managing ectopic pelvic kidney calculi using laparoscopic approach for percutaneous nephrolithotomy (PCNL) in chronic kidney disease patients.

SUBJECTS AND METHODS

Patients with calculi in ectopic kidney with increased serum creatinine level secondary to obstruction were included in the study. Initially, obstruction was relieved. Patients later underwent laparoscopic-assisted PCNL. Patients were monitored postoperatively.

RESULTS

Three patients with large renal calculi in ectopic pelvic kidney had presented in 2 years. Laparoscopic-assisted PCNL was done to remove the stone. Patients had persistent urine leak post-operatively. Mean duration for removal of nephrostomy tube and drain removal were 4.67 days and 6.67 days, respectively. These patients also had paralytic ileus for prolonged duration.

CONCLUSION

Although laparoscopic assisted PCNL is an option in the management of patients with stone disease in ectopic pelvic kidney, prolonged time for healing of tract may increase postoperative morbidity in these patients with impaired renal function.

摘要

目的

肾功能紊乱的患者存在多种相关因素,这些因素会损害伤口愈合并增加术后发病率。本研究旨在评估慢性肾病患者采用腹腔镜辅助经皮肾镜取石术(PCNL)治疗异位盆腔肾结石时所面临的问题。

研究对象与方法

本研究纳入血清肌酐水平因梗阻而升高的异位肾结石患者。首先解除梗阻,随后患者接受腹腔镜辅助PCNL。术后对患者进行监测。

结果

2年内有3例异位盆腔肾的大肾结石患者前来就诊。采用腹腔镜辅助PCNL取出结石。患者术后持续漏尿。肾造瘘管拔除和引流管拔除的平均时间分别为4.67天和6.67天。这些患者还出现了长时间的麻痹性肠梗阻。

结论

尽管腹腔镜辅助PCNL是治疗异位盆腔肾结石疾病患者的一种选择,但对于这些肾功能受损的患者,通道愈合时间延长可能会增加术后发病率。

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