Liu Honglei, Gao Wenzhi, Zhang Zheng, Yang Kunlin, Meng Chang, Wang Bing, Han Yangjun, Diao Mingxin, Zuo Chao, Zhang Minghua, Diao Yingzhi, Li Zhihua, Li Xinfei, Wang Gang, Wang Chunji, Gao Zihui, Gu Yaming, Li Xuesong
Department of Urology, Peking University First Hospital-Miyun Hospital, Beijing, China.
Department of Urology, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Curr Urol. 2025 May;19(3):168-172. doi: 10.1097/CU9.0000000000000238. Epub 2024 Mar 12.
Percutaneous nephropexy (PCN) has been demonstrated as a feasible method for treating nephroptosis. This study describes an improved technique for PCN that better addresses the issue of nephroptosis.
We reviewed 4 patients who underwent the improved PCN procedure between January 2021 and January 2023. These patients were diagnosed with nephroptosis, with 1 case having both a narrow ureteropelvic junction and nephroptosis due to a kidney stone, and 3 cases having simple nephroptosis. Patient characteristics, perioperative data, and follow-up results were collected. Surgical success was determined by symptom relief (subjective success) and the absence of kidney descent by intravenous pyelography (objective success).
Preoperative computed tomography urography showed that all patients had hydronephrosis, with severe hydronephrosis in 75% (3/4) and moderate hydronephrosis in 25% (1/4) of cases. The mean operative time was 63.8 minutes (range, 45-95 minutes), and the mean blood loss was 5 mL (range, 5-50 mL). The mean length of hospital stay was 4.5 days (range, 3-6 days). The mean time to removal of the nephrostomy tube was 2 months (range, 1-4 months). No serious complications (Clavien-Dindo grade ≥3) occurred during or after the procedure. The mean postoperative serum creatinine level was 54.75 μmol/L (range, 43-65 μmol/L). The mean follow-up time was 6.25 months (range, 4-8 months). The objective and subjective success rates were both 100%.
The improved PCN procedure that was used in this study is feasible and provides a good option for treating nephroptosis.
经皮肾固定术（PCN）已被证明是治疗肾下垂的一种可行方法。本研究描述了一种改进的PCN技术，该技术能更好地解决肾下垂问题。
我们回顾了2021年1月至2023年1月期间接受改良PCN手术的4例患者。这些患者被诊断为肾下垂，其中1例因肾结石导致输尿管肾盂连接处狭窄并伴有肾下垂，3例为单纯性肾下垂。收集了患者的特征、围手术期数据和随访结果。手术成功的判定标准为症状缓解（主观成功）以及静脉肾盂造影显示肾脏无下移（客观成功）。
术前计算机断层扫描尿路造影显示，所有患者均有肾积水，其中75%（3/4）为重度肾积水，25%（1/4）为中度肾积水。平均手术时间为63.8分钟（范围45 - 95分钟），平均失血量为5毫升（范围5 - 50毫升）。平均住院时间为4.5天（范围3 - 6天）。肾造瘘管拔除的平均时间为2个月（范围1 - 4个月）。术中及术后未发生严重并发症（Clavien-Dindo分级≥3级）。术后血清肌酐平均水平为54.75μmol/L（范围43 - 65μmol/L）。平均随访时间为6.25个月（范围4 - 8个月）。客观和主观成功率均为100%。
本研究中使用的改良PCN手术是可行的，为治疗肾下垂提供了一个良好的选择。
