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
Clinical Hospital at Nizhny Novgorod Railway Station of JSC RZD, Nizhny Novgorod, Russia.
Department of Faculty Surgery 1, A.I. Evdokimov MSUMD, Moscow, Russia.
Urologiia. 2017 Jul(3):40-45. doi: 10.18565/urol.2017.3.40-45.
To analyze the effectiveness and safety of laparoscopic pyelolithotomy (LP) in treating staghorn stones.
A multicentre retrospective analysis of the results of LP performed from January 2004 to December 2016 was conducted.
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.
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.
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.
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。
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。
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。
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。
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。
