Singh Dongol Udaya Man, Bohora Sandeep
Department of Urosurgery, Kathmandu Medical College and Teaching Hospital, Kathmandu.
J Nepal Health Res Counc. 2018 Oct 30;16(3):274-278.
Urolithiasis is a worldwide problem due to its high prevalence and recurrence. Percutaneous nephrolithotomy is a minimally invasive surgical option for the treatment of large renal stone burden greater than 20mm, staghorn calculi and lower pole calyceal stone greater than 10 mm. The objective of this study was to evaluate the safety and efficacy of percutaneous nephrolithotomy in the management of lower pole calyceal stones.
Seventy patients who presented in between June 2013 and September 2017 with lower pole calyceal stones and lower calyceal stones with pelvic extension were included in the study. The operating time, the hospital stay, complications rate, stone clearance rate were all noted. Patients were followed up in three and six weeks with X-ray KUB and ultrasonography of abdomen.
Seventy adult patients with lower pole calyceal stones underwent standard percutaneous nephrolithotomy. The mean age was 32 years (18-71 yrs). The mean stone size was 17.6 mm (15 -28 mm). The mean operating time was 62 minutes (48-124 mins) and hospital stay was 4.1 days(4-8 days). The stone clearance rate was 92.6% for stone <20mm and 90.7% stone size >20 mm. The complications noted were fever (8.5%), transient haematuria (20%), urine leak (5.7%), obstruction by residual fragments (5.7%) and one pseudoaneurysm(1.42%). Seven patients (10%) needed blood transfusion.
Percutaneous nephrolithotomy is a safe, feasible and highly effective method for the treatment of lower pole calyceal stones.
尿石症因其高发病率和复发率成为一个全球性问题。经皮肾镜取石术是治疗直径大于20mm的巨大肾结石、鹿角形结石以及直径大于10mm的下极肾盏结石的一种微创手术选择。本研究的目的是评估经皮肾镜取石术治疗下极肾盏结石的安全性和有效性。
纳入2013年6月至2017年9月间出现下极肾盏结石及伴有肾盂延伸的下肾盏结石的70例患者。记录手术时间、住院时间、并发症发生率、结石清除率。术后3周和6周对患者进行腹部X线KUB和超声检查随访。
70例患有下极肾盏结石的成年患者接受了标准经皮肾镜取石术。平均年龄为32岁（18 - 71岁）。平均结石大小为17.6mm（15 - 28mm）。平均手术时间为62分钟（48 - 124分钟），住院时间为4.1天（4 - 8天）。结石直径<20mm的结石清除率为92.6%，结石直径>20mm的结石清除率为90.7%。观察到的并发症有发热（8.5%）、短暂性血尿（20%）、尿漏（5.7%）、残余碎片梗阻（5.7%）和1例假性动脉瘤（1.42%）。7例患者（10%）需要输血。
经皮肾镜取石术是治疗下极肾盏结石的一种安全、可行且高效的方法。
