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经皮肾镜碎石术联合顺行球囊扩张治疗肾结石合并复发性肾盂输尿管连接部梗阻。

Concomitant management of renal calculi and recurrent ureteropelvic junction obstruction with percutaneous nephrolithotomy and antegrade balloon dilation.

机构信息

Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China.

出版信息

J Int Med Res. 2020 May;48(5):300060520911252. doi: 10.1177/0300060520911252.

Abstract

OBJECTIVE

This study aimed to present our experience of concomitant management of renal calculi and recurrent ureteropelvic junction obstruction (UPJO) with percutaneous nephrolithotomy (PCNL) and antegrade balloon dilation.

METHODS

We retrospectively reviewed 31 patients who underwent PCNL and antegrade balloon dilation for treatment of renal calculi and recurrent UPJO. The inclusion criterion was the presence of UPJO after failed pyeloplasty with ipsilateral renal calculi. Success was defined as achievement of both symptomatic and radiographic resolution of any stones and obstruction.

RESULTS

All operations were successful without grade III or higher postoperative complications. A stone-free status was observed in all patients and the overall success rate of the procedure was 87.1% (27/31). The success rate of the procedure was significantly higher in patients with mild or moderate preoperative hydronephrosis (96%) than in those with high-grade preoperative hydronephrosis (50%). Moreover, the success rate of the procedure was lower in patients with poor preoperative renal function (0%) than in those with good or moderate renal function (93.1%).

CONCLUSION

Combined PCNL and antegrade balloon dilation management represents a safe and effective approach for patients with renal calculi and recurrent UPJO after failed pyeloplasty.

摘要

目的

本研究旨在介绍我们应用经皮肾镜碎石术(PCNL)联合顺行球囊扩张治疗肾结石合并复发性肾盂输尿管连接部梗阻(UPJO)的经验。

方法

我们回顾性分析了 31 例接受 PCNL 和顺行球囊扩张治疗肾结石合并复发性 UPJO 的患者。纳入标准为肾盂成形术后同侧肾结石伴 UPJO 复发。成功定义为所有结石和梗阻的症状和影像学均得到缓解。

结果

所有手术均成功,无 III 级及以上术后并发症。所有患者均达到无结石状态,手术总成功率为 87.1%(27/31)。术前轻中度肾积水患者的成功率(96%)明显高于术前重度肾积水患者(50%)。此外,术前肾功能差的患者(0%)手术成功率明显低于肾功能良好或中度的患者(93.1%)。

结论

对于肾盂成形术后肾结石合并复发性 UPJO 的患者,联合 PCNL 和顺行球囊扩张治疗是一种安全有效的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6782/7218938/fe1d51654c14/10.1177_0300060520911252-fig1.jpg

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