Abstract:Objective To investigate the feasibity and effcacy of ureteroscopic lithotripsy combined with percutaneous nephrolithotripsy for complex upper urinary tract calculi. Methods This study included 56 patients with complex renal stones(staghorn or multiple calculi or large stones) and ipsilateral ureteral stones who underwent ureteroscopic lithotripsy combined with percutaneous nephrolithotripsy.All cases were diagnosed by B-mode ultrasound,KUB+IVU and kidney CT,and all cases were complicated by different degree of hydronephrosis.Firstly,the patients underwent ureteroscopic lithotripsy with holmium laser,then underwent percutaneous nephrolithotripsy with the fourth-generation EMS pneumatic and ultrasound lithotripsy. Results The operations were completed successfully in all the 56 cases and no one turned to open surgery during the lithotripsy.The complete liquidation rate of the stones at stage I treatment was 78.6%,at stage Ⅱ was 80.0%,and the overall rate of stone liquidation was 92.8%. Conclusions The simultaneous treatment of complex renal complex renal stones accompanied by ipsilateral ureter stones becomes reality by ureteroscopic lithotripsy combined with percutaneous nephrolithotripsy,and there was no need for EWSL before opertation.This method has the advantages of safety,high efficacy,convenience and practicality.
杨波,李建兴,胡卫国,等两步法建立标准通道经皮肾镜取石3052例临床报告[J].北京大学学报(医学版),2010,42(4):447-450.[2]Rastinehad A R,Andonian S,Smith A D,et al.Management of hemorrhagic complications associated with percutaneous nephrolithotomy[J].Endourol,2009,23:1763-1767.[3]Shalaby M M, Abdalla M A, Aboul-Ella H A,et al. Single puncture percutaneous nephrolithomy for management of complex renal stones[J]. BMC Res Notes,2009,2:62.[4]叶利洪,陈永良,许德顺,等.上尿路结石五种微创手术的临床比较分析[J].中华医学杂志, 2010,90(4):228-230.[5]谭剑敏,高赟,徐丹枫,等.输尿管上段结石的治疗选择[J].中华外科杂志,2009,47(23):1827-1828.[6]Gunlusey B,Degirmenci T,Arslan M,et al.Ureteroscopic pneumatic lithotripsy:is the location of the stone important in decision making Analysis of 1296 patients[J].Endourol,2008,22:29l-294.