Department of Urology, Beijing Jishuitan Hospital, No68.Huinanbei Road, Changping District, Beijing, 100096, China.
BMC Urol. 2020 Jun 17;20(1):70. doi: 10.1186/s12894-020-00640-3.
Percutaneous nephrolithotomy is traditionally performed in the prone or supine position. We report the first case of percutaneous nephrolithotomy in sit position under local infiltration anesthesia. A 69-year-old male presented with left flank pain. Kidney B ultrasound and computed tomography scan showed multiple left renal calculi and hydronephrosis. He had a long history of chronic obstructive pulmonary disease, with severe ventilatory and cardiac dysfunction, and cannot tolerate the prone or supine position. The patient received the surgery in sit position under local infiltration anesthesia. The operative time was 1 h. The visual analogue scale score during the surgery was 3. The patient had no intraoperative and postoperative complications. The postoperative plain radiography showed no residual stone fragments.
We believe that in high-risk patients who need to undergo PCNL, a combination of sit position and local infiltration anesthesia is an alternative method.
经皮肾镜取石术传统上采用俯卧位或仰卧位进行。我们报告首例在局部浸润麻醉下坐位行经皮肾镜取石术的病例。一名 69 岁男性因左侧腰痛就诊。肾脏 B 超和 CT 扫描显示左肾结石和肾积水多发。他患有慢性阻塞性肺疾病，呼吸和心脏功能严重受损，无法耐受俯卧位或仰卧位。患者在局部浸润麻醉下接受坐位手术。手术时间为 1 小时。手术过程中的视觉模拟评分（VAS）为 3 分。患者术中术后均无并发症。术后平片未见残留结石碎片。
我们认为，对于需要接受经皮肾镜取石术的高危患者，坐位与局部浸润麻醉相结合是一种替代方法。
