[1]葛建章*,傅发军,刘玉明.斜仰卧截石位经皮肾镜联合输尿管镜治疗双J管滞留致全程附壁结石5例报告[J].中国微创外科杂志,2017,17(11):1044-1047.
　Ge Jianzhang,Fu Fajun,Liu Yuming..Percutaneous Nephrolithotomy Combined with Semirigid Ureteroscopic Lithotripsy in Semisupine-lithotomy Position for Encrusted Ureteral Stents: Report of 5 Cases[J].Chinese Journal of Minimally Invasive Surgery,2017,17(11):1044-1047.
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斜仰卧截石位经皮肾镜联合输尿管镜治疗双J管滞留致全程附壁结石5例报告()

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年11期
页码:
1044-1047
栏目:
经验交流
出版日期:
2017-11-20

文章信息/Info

Title:
Percutaneous Nephrolithotomy Combined with Semirigid Ureteroscopic Lithotripsy in Semisupine-lithotomy Position for Encrusted Ureteral Stents: Report of 5 Cases
作者:
葛建章*; 傅发军; 刘玉明
长沙市中心医院泌尿外科，长沙410004
Author(s):
Ge Jianzhang;  Fu Fajun;  Liu Yuming.
Department of Urology, Changsha Central Hospital, Changsha 410004, China
关键词:
经皮肾镜取石术; 输尿管镜; 斜仰卧截石位
Keywords:
Percutaneous nephrolithotomy; Ureteroscopy; Semisupine-lithotomy position
文献标志码:
B
摘要:
目的探讨斜仰卧截石位经皮肾镜联合输尿管镜治疗双J管滞留致全程附壁结石的安全性及可行性。方法斜仰卧截石位，经尿道输尿管镜下钬激光击碎双J管膀胱段结石和输尿管内双J管附壁结石，经皮肾镜钬激光碎石术处理肾盂段双J管附壁结石和肾内新发结石。结果5例均一期完成碎石并完整取出双J管，无一例术中改开放手术。手术时间平均65 min（40~130 min），术中无严重肾脏出血，无输尿管穿孔及撕脱。术后2例发热，无尿脓毒血症性休克发生。5例随访3~6个月，未见结石复发及输尿管狭窄形成。结论斜仰卧截石位经皮肾镜联合输尿管镜钬激光碎石术治疗双J管滞留致全程附壁结石安全、有效，值得临床推广。
Abstract:
ObjectiveTo evaluate the safety and efficacy of percutaneous nephrolithotomy with semirigid ureteroscopic lithotripsy in semisupine-lithotomy position for treatment of encrusted ureteral stents.MethodsPatients were placed in semisupine-lithotomy position. The bladder stones and ureteral encrusted stones were treated with ureteroscopy, and then percutaneous holmium laser nephrolithotomy was used to break and wash out the renal pelvis stones and renal new stones. ResultsThe stone fragmentation and stent removal were completed in one session in all 5 cases without conversion to open surgery. The mean operative time was 65 min (range, 40-130 min). No massive hemorrhage, ureteral avulsion, or ureteral perforration occurred during the operation. Two cases had postoperative fever without sepsis. No patients had ureteral stricture or recurrent calculus within follow-ups for 3-6 months. ConclusionPercutaneous nephrolithotomy combined with semirigid ureteroscopic lithotripsy in semisupine-lithotomy position for treatment of encrusted ureteral stents is safe and effective, being worthy of clinical promotion.

参考文献/References:

[1]Zimskind PD, Fetter TR, Wilkerson JL. Clinical use of long-term indwelling silicone rubber ureteral splints inserted cystoscopically. J Urol,1967,97(5):840-844.
[2]Muslumanoglu AY, Fuglsig S, Frattini A, et al. Risks and benefits of postoperative double-J stent placement after ureteroscopy (URS): results from the clinical research office of endourological society urs global study. J Endourol,2017,31(5):446-451.
[3]Isero T, Hamamoto S, Koiwa S, et al. Combined endoscopic surgery in the prone-split leg position for successful single-session removal of an encrusted ureteral stent: a case report. J Med Case Rep,2014,8(5):128-134.
[4]Vanderbrink BA, Rastinehad AR, Ost MC, et al. Encrusted urinary stents: evaluation and endourologic management. J Endourol,2008,22(5):905-912.
[5]Kawahara T, Ito H, Terao H, et al. Ureteral stent encrustation, incrustation, and coloring: morbidity related to indwelling times. J Endourol,2012,26(2):178-182.
[6]Aron M, Ansari MS, Singh I, et al. Forgotten ureteral stents causing renal failure: multimodal endourologic treatment. J Endourol,2006,20(6):423-428.
[7]Xu C, Tang H, Gao X, et al. Management of forgotten ureteral stents with holmium laser. Lasers Med Sci,2009,24(2):140-143.
[8]Thomas A, Cloutier J, Villa L, et al. Prospective analysis of a complete retrograde ureteroscopic technique with holmium laser stent cutting for management of encrusted ureteral stents. J Endourol,2017,31(5):476-481.
[9]Sancaktutar AA, Sylemez H, Bozkurt Y, et al. Single session removal of forgotten encrusted ureteral stents: combined endourological approach. Urol Res,2012,40(5):613.
[10]许可慰,张彩霞,郭正辉,等.斜仰卧-截石位经皮肾镜取石术治疗复杂性肾结石.中华腔镜泌尿外科杂志（电子版）,2012,6(5):5-8.
[11]谢圣陶,陈广瑜.斜仰卧截石位经皮肾镜联合输尿管镜处理输尿管上段复杂结石.中国微创外科杂志,2014,14(4):348-349,369.

备注/Memo

备注/Memo:
*通讯作者，E-mail：744120192@qq.com
更新日期/Last Update: 2018-02-23