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[腹腔镜肾盂切开取石术治疗鹿角形肾结石。多中心研究]

[Laparoscopic pyelolithotomy for staghorn kidney stones. multi-center study].

作者信息

Kochkin A D, Gallyamov E A, Medvedev V L, Biktimirov R G, Martov A G, Sevryukov F A, Novikov A B, Sanzharov A E, Sergeev V P

机构信息

Clinical Hospital at Nizhny Novgorod Railway Station of JSC RZD, Nizhny Novgorod, Russia.

Department of Faculty Surgery 1, A.I. Evdokimov MSUMD, Moscow, Russia.

出版信息

Urologiia. 2017 Jul(3):40-45. doi: 10.18565/urol.2017.3.40-45.

Abstract

AIM

To analyze the effectiveness and safety of laparoscopic pyelolithotomy (LP) in treating staghorn stones.

MATERIALS AND METHODS

A multicentre retrospective analysis of the results of LP performed from January 2004 to December 2016 was conducted.

INCLUSION CRITERIA

patients with staghorn calculi K3-K4, who underwent LP as an alternative to percutaneous nephrolithotripsy. The analysis included the incidence and structure of intra- and postoperative complications, the causes of access conversion, operating time, duration of postoperative hospital stay and stone clearance.

RESULTS

A total of 137 patients met the inclusion criteria, including 78 (56.93%) men. There was no mortality and access conversion. Intraoperative complications occurred in 2 (1.46%) patients. Operating time was 130 [100; 150] min, blood loss was 150 [100; 200] ml. No need for blood transfusion was observed. The cumulative rate of postoperative complications was 5.11%, stone clearance was achieved in 86.13% of observations, the duration of postoperative hospital stay was 7 [7; 11] days.

CONCLUSION

In cases of dense staghorn calculi located in a large "extra-renal" pelvis and have calyceal branches equal to the diameter of their necks, laparoscopic pyelolithotomy is an alternative not only to open, but also to percutaneous surgery.

摘要

目的

分析腹腔镜肾盂切开取石术(LP)治疗鹿角形结石的有效性和安全性。

材料与方法

对2004年1月至2016年12月期间进行的LP手术结果进行多中心回顾性分析。

纳入标准

K3 - K4级鹿角形结石患者,接受LP手术作为经皮肾镜碎石术的替代方案。分析内容包括术中及术后并发症的发生率和构成、中转开放手术的原因、手术时间、术后住院时间及结石清除情况。

结果

共有137例患者符合纳入标准,其中男性78例(56.93%)。无死亡病例及中转开放手术情况。2例(1.46%)患者发生术中并发症。手术时间为130[100;150]分钟,出血量为150[100;200]毫升,未观察到输血需求。术后并发症累积发生率为5. + 11%,86.13%的患者结石清除,术后住院时间为7[7;11]天。

结论

对于位于大“肾外”肾盂且肾盏分支直径与其颈部直径相等的致密鹿角形结石病例,腹腔镜肾盂切开取石术不仅是开放手术的替代方案,也是经皮手术的替代方案。

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