Gómez-Regalado Francisco, Manzo Braulio Omar, Figueroa-Garcia Alejandro, Sanchez-Lopez Hector, Basulto-Martinez Mario, Cracco Cecilia Maria, Scoffone Cesare Marco
Department of Urology, CU Providencia, Jalisco, México.
Department of Urology, Hospital Regional de Alta Especialidad del Bajio, Guanajuato, México.
J Endourol Case Rep. 2020 Sep 17;6(3):205-208. doi: 10.1089/cren.2019.0181. eCollection 2020.
Crossed fused renal ectopia (CFRE) is an unusual anomaly in which both kidneys lie fused on one side, with double pelvis and ureters draining into both sides of the bladder. Complex renal stones are a considerable challenge to endourologists, and when a staghorn stone is associated with abnormal anatomy, its treatment is even more difficult. Today there is no consensus about the right treatment for complex renal stones in CFRE. So, the objective of this case is to present the efficacy of the endoscopic combined intrarenal surgery (ECIRS) for the treatment of a staghorn renal stone in one patient with CFRE. We described a case of a 23-year-old man with prolonged lasting and pain on the left flank associated with intermittent gross hematuria. Enhanced CT revealed a crossed fused kidney on the left side, drained by an intercommunicating pelvis and a single ureter, with a staghorn stone wholly occupying both renal units. The patient was effectively treated by one single session of ECIRS. The ECIRS is a good alternative to consider in patients with CFRE that have a staghorn calculus with a reasonable success rate.
交叉融合肾异位(CFRE)是一种罕见的异常情况,即双侧肾脏融合于一侧,伴有双肾盂和输尿管分别引流至膀胱两侧。复杂性肾结石对内窥镜泌尿外科医生来说是一项巨大挑战,当鹿角形结石合并解剖结构异常时,其治疗难度更大。目前对于CFRE中复杂性肾结石的正确治疗方法尚无共识。因此,本病例的目的是展示内镜联合肾内手术(ECIRS)治疗1例CFRE患者鹿角形肾结石的疗效。我们描述了1例23岁男性患者,其左侧腰部长期持续疼痛并伴有间歇性肉眼血尿。增强CT显示左侧为交叉融合肾,由一个相互连通的肾盂和一条单一输尿管引流,一枚鹿角形结石完全占据了两个肾单位。该患者通过单次ECIRS治疗取得了良好效果。对于患有鹿角形结石的CFRE患者,ECIRS是一种值得考虑的较好选择,成功率较为合理。