腹膜后腹腔镜肾盂切开取石术治疗>3cm肾盂单发结石的临床观察

528403 广东中山,南方医科大学附属中山博爱医院泌尿外科

肾盂结石;腹腔镜;经皮肾镜

Clinical observation of retroperitoneal laparoscopic pyelolithotomy for single renal pelvic calculi (>3 cm)
Ling Feng, Xie Qun.

Department of Urology, Zhongshan Boai Hospital of Southern Medical University, Guangdong 528430, China

Penal pelvis calculi; Laparoscopy; PCNL

DOI: 10.3877/cma.j.issn.1674-3253.2018.03.013

备注

目的 观察腹膜后腹腔镜肾盂切开取石术治疗 >3cm肾盂单发结石的疗效。方法 选取 2013年 8月至 2015年 8月我院肾盂单发较大结石 80例,对照组采用单通道经皮肾镜碎石取石术,实验组患者采用腹腔镜肾盂切开取石术。观察两组患者手术时间、出血量、肠道恢复时间、引流时间、住院时间、住院总费用。比较两组使用止痛药、结石清除率及并发症发生率。结果 实验组止痛药使用率 5.00 %少于对照组 22.50 %(P<0.05)。实验组结石清除率为 100.00 %高于对照组 82.50 %(P<0.05)。实验组患者手术时间、住院费用高于对照组(P<0.01)。实验组患者出血量、肠道恢复时间、引流时间、住院天数少于对照组(P<0.01)。实验组患者并发症发生情况优于对照组(P<0.01)。结论 腹膜后腹腔镜肾盂切开取石术治疗肾盂单发较大结石清除率高,具有出血量少、住院时间短、术后并发症少的特点。
Objective To investigate the clinical efficacy of retroperitoneal laparoscopic pyelolithotomy for single renal pelvic calculi(>3 cm). Methods Eighty cases with large and single renal pelvic calculi in our hospital were divided into a control group and an experimental group from Angust 2013 to Angust 2015. Patients in the control group were treated with single channel percutaneous nephrolithotomy, whereas those in the experimental group were treated with retroperitoneal laparoscopic pyelolithotomy. The operation duration, bleeding volume, recovery time of intestinal tract, drainage time, hospital stay, hospitalization expenses of the two groups were observed and compared. The percentage of patients using painkillers, rate of stone clearance and the incidence of complications were compared between the two groups. Results Percentage of patients using painkillers in the experimental group was 5.00%, less than that in the control group, which was 22.50%(P<0.05). The rate of stone clearance in the experimental group was 100%, higher than that in the control group, which was 82.50%(P<0.05). The operation duration and hospitalization expenses in the experimental group were longer and higher than those in the control group (P<0.01). The amount of bleeding, recovery time of intestinal tract, drainage time and hospital stay in experimental group were less than those in control group(P<0.01). The incidence of complications in the experimental group was less than that in the control group(P<0.01). Conclusion Retroperitoneal laparoscopic pyelolithotomy is effective for large and single renal pelvic calculi, with advantages of higher removal rate, less bleeding, shorter hospital stay and less postoperative complications.
·