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使用软性膀胱镜同时进行肾盂切开取石术的后腹腔镜肾盂成形术:我们在单一中心的初步经验。

Retroperitoneoscopic pyeloplasty with simultaneous pyelolithotomy using a flexible cystoscope: Our initial experience at a single centre.

作者信息

Zhang Fei, Wang Li, Gao ZheBin, Yang HouMeng

机构信息

Department of Urology, Hwa Mei Hospital, University of Chinese Academy of Sciences (Ningbo No.2 Hospital), Ningbo, China.

出版信息

Front Surg. 2022 Aug 19;9:938911. doi: 10.3389/fsurg.2022.938911. eCollection 2022.

Abstract

PURPOSE

We present our experience with retroperitoneoscopic pyeloplasty with simultaneous pyelolithotomy using a flexible cystoscope in patients with ureteropelvic junction obstruction(UPJO) complicated with kidney stones.

MATERIALS AND METHODS

The records of 37 patients who underwent retroperitoneoscopic pyeloplasty with simultaneous pyelolithotomy using a flexible cystoscope to manage UPJO complicated with kidney stones from July 2015 to December 2020 were retrospectively reviewed. All patients underwent one-stage retroperitoneoscopic pyeloplasty combined with flexible cystoscopic pyelolithotomy. The operative time, blood volume, stone clearance rate, length of hospital stay, complications and follow-up events were recorded.

RESULTS

The operation went smoothly in all 37 patients. The mean operative time was 148.4 ± 24.2 min. The mean intraoperative blood loss volume was 54.3 ± 20.5 ml. The mean hospitalization time was 10.6 ± 3.7 days. The stone clearance rate was 81.08%. The mean follow-up period was 23.5 months (range 12-53 months). Hydronephrosis was significantly decreased in 33 of the 37 cases. The success rate of the operation was 89.19%. Stones recurred in 9 patients during follow-up, for a recurrence rate of 24.32%.

CONCLUSION

Retroperitoneoscopic pyeloplasty with simultaneous pyelolithotomy using a flexible cystoscope in patients with UPJO complicated with kidney stones is safe, effective and worthy of promotion.

摘要

目的

我们介绍在输尿管肾盂连接部梗阻(UPJO)合并肾结石患者中,使用软性膀胱镜同时进行肾盂切开取石术的后腹腔镜肾盂成形术的经验。

材料与方法

回顾性分析2015年7月至2020年12月期间,37例行后腹腔镜肾盂成形术并使用软性膀胱镜同时进行肾盂切开取石术以治疗UPJO合并肾结石的患者的病历。所有患者均接受一期后腹腔镜肾盂成形术联合软性膀胱镜肾盂切开取石术。记录手术时间、出血量、结石清除率、住院时间、并发症及随访情况。

结果

37例患者手术均顺利完成。平均手术时间为148.4±24.2分钟。术中平均失血量为54.3±20.5毫升。平均住院时间为10.6±3.7天。结石清除率为81.08%。平均随访时间为23.5个月(范围12 - 53个月)。37例中有33例肾盂积水明显减轻。手术成功率为89.19%。随访期间9例患者结石复发,复发率为24.32%。

结论

对于UPJO合并肾结石的患者,使用软性膀胱镜同时进行后腹腔镜肾盂成形术和肾盂切开取石术是安全、有效的,值得推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffe1/9437547/9c981bc254a7/fsurg-09-938911-g001.jpg

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