病例报告：交叉融合性肾异位伴结石：机器人手术成功应对的外科挑战
Case report: Crossed fused renal ectopia with stones: A surgical challenge overcome by robotic surgery.
作者信息
Chai Jiagui, Ke Changxing
机构信息
Department of Urology, the Second Affiliated Hospital of Kunming Medical University, Kunming, China.
Yunnan Institute of Urology, Kunming, China.
出版信息
Int J Med Robot. 2023 Jul 26:e2557. doi: 10.1002/rcs.2557.
BACKGROUND
Crossed fused renal ectopia (CFRE) is an extremely rare congenital anomaly of the urinary tract that is prone to stone formation. The surgical treatment of CFRE with stones is challenging due to anatomical abnormalities.
MATERIALS AND METHODS
Right kidney stones were treated by flexible ureteroscopic lithotripsy (FURSL) and left kidney stones were treated by robotic surgery.
RESULTS
The authors present an unreported case of bilateral renal stones in a patient with CFRE, which was successfully treated by robotic pyelolithotomy combined with FURSL. The procedure was manoeuverable, and the stone-free rate was satisfactory.
CONCLUSIONS
CFRE with stones (S-shaped kidney) present a surgical challenge due to anatomical abnormalities and a high stone burden. The authors recommend robotic pyelolithotomy with or without FURSL as a viable treatment option for stones with similar anatomical abnormalities.
背景
交叉融合性肾异位（CFRE）是一种极为罕见的先天性泌尿系统异常，易于形成结石。由于解剖结构异常，对合并结石的CFRE进行手术治疗具有挑战性。
材料与方法
右侧肾结石采用软性输尿管镜碎石术（FURSL）治疗，左侧肾结石采用机器人手术治疗。
结果
作者报告了1例CFRE患者双侧肾结石的罕见病例，该病例通过机器人肾盂切开取石术联合FURSL成功治疗。手术操作简便，结石清除率令人满意。
结论
合并结石的CFRE（S形肾）由于解剖结构异常和结石负荷高，带来了手术挑战。作者推荐采用有或没有FURSL的机器人肾盂切开取石术作为治疗具有类似解剖结构异常结石的可行治疗选择。
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