학술논문

外置输尿管导管的无管化微通道经皮肾镜取石术(附21例报告) / External Ureteral Catheterization of Tubeless Mini-percutaneous Nephrolithotomy:Report of 21 Cases
Document Type
Academic Journal
Source
中国微创外科杂志(中英文) / Chinese Journal of Minimally Invasive Surgery. 23(12):950-953
Subject
外置输尿管导管
无管化
经皮肾镜术
单发结石
External ureteral catheter
Tubeless
Percutaneous nephrolithotomy
Single calculus
Language
Chinese
ISSN
1009-6604
Abstract
目的 评价外置输尿管导管的无管化微通道经皮肾镜取石术(mini-percutaneous nephrolithotomy,mini-PCNL)治疗单发泌尿系结石的有效性、安全性.方法 回顾性分析2021 年6 月~2022 年12 月无管化mini-PCNL治疗21 例单发肾、输尿管上段结石的资料.肾结石16 例,输尿管上段结石5 例,结石长径1.5~3.5 cm,(2.07±0.56)cm.先经膀胱镜留置输尿管导管后留置导尿,并将输尿管导管和导尿管固定,行mini-PCNL后无残留结石,则撤除Peel-away鞘,缝合切口.结果手术均顺利完成,术后3~5d拔除导尿管及输尿管导管后出院.术后均有轻微肉眼血尿,发热 3 例,肾周血肿 4 例,无尿外渗.出院后1 个月复查B超或CT平扫,未见结石,肾周无尿囊肿和血肿形成.结论 对于经过选择的病例(单发,非鹿角形结石,术中无结石残留,无输尿管狭窄),外置输尿管导管无管化mini-PCNL安全有效.
Objective To evaluate the efficacy and safety of external ureteral catheterization of tubeless mini-percutaneous nephrolithotomy(mini-PCNL)in the treatment of single urinary calculus.Methods Clinical data of 21 patients with single renal or upper ureteral calculi treated with tubeless mini-PCNL from June 2021 to December 2022 were retrospectively analyzed.Among them,there were16 cases of kidney stones and5 cases of upper ureteral stones.The length of stones was1.5-3.5 cm(mean,2.07±0.56 cm).The ureteral catheter was indwelled by cystoscope and retained for catheterization,and the ureteral catheter and catheterization were fixed.If there were no residual stones after mini-PCNL,the Peel-away sheath was removed and the incision was sutured.Results All the operations were successfully completed,and the catheterization and ureteral catheter were removed 3-5 days after operation.There were slight gross hematuria in all the cases,fever in 3 cases,perirenal hematoma in 4 cases,and no urinary extravasation postoperatively.One month after discharge,B-ultrasonography or CT scanning showed no lithiasis,urinary cyst or hematoma formation around the kidney.Conclusion In selected cases(single and non-staghorn stones,without intraoperative stone residue or ureteral stenosis),external ureteral catheterization of tubeless mini-PCNL is safe and effective.