[1]邱敏 宗亚楠① 李焕荣② 赵磊＊卢剑 侯小飞 刘承 马潞林.一期微创手术治疗肾肿物合并输尿管结石[J].中国微创外科杂志,2018,18(11):1027-1029.
　Qiu Min*,Zong Yanan,Li Huanrong,et al.Simultaneous Minimally Invasive Surgery for Renal Mass Combined With Ureteral Calculi[J].Chinese Journal of Minimally Invasive Surgery,2018,18(11):1027-1029.
点击复制

一期微创手术治疗肾肿物合并输尿管结石()
分享到：

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

卷:
18
期数:
2018年11期
页码:
1027-1029
栏目:
经验交流
出版日期:
2018-11-20

文章信息/Info

Title:
Simultaneous Minimally Invasive Surgery for Renal Mass Combined With Ureteral Calculi
作者:
邱敏 宗亚楠① 李焕荣② 赵磊＊卢剑 侯小飞 刘承 马潞林
(北京大学第三医院泌尿外科，北京100191)
Author(s):
Qiu Min*;  Zong Yanan;  Li Huanrong;  et al.
*Department of Urology, Peking University Third Hospital, Beijing 100191, China
关键词:
肾肿瘤; 输尿管结石; 同期手术
Keywords:
Kidney neoplasms; Ureteral calculi; Simultaneous operations
文献标志码:
B
摘要:
目的探讨一期微创手术治疗肾肿物合并输尿管结石的安全性和可行性。方法回顾性分析2011年3月~2018年5月同期治疗肾肿物合并结石11例资料。肾肿物左侧7例，右侧4例，5例肾囊肿长径4.2~5.8 cm，平均4.9 cm，6例肾实性肿瘤长径1.7~4.1 cm，平均2.4 cm。输尿管结石9例与肾肿物同侧，2例为对侧。先行输尿管镜碎石取石术，再行后腹腔镜肾囊肿开窗或肾部分切除术。结果5例肾囊肿行输尿管镜碎石取石+后腹腔镜肾囊肿开窗术，手术时间72~226 min，平均122.8 min，出血量5~10 ml，无输血，术后住院时间4~7 d，平均4.8 d，未见明显并发症，病理均为肾囊肿；6例肾实性肿瘤行输尿管镜碎石取石+后腹腔镜肾部分切除术，手术时间158~314 min，平均220.3 min，出血量20~100 ml，中位数20 ml，无输血，术后住院时间6~11 d，平均7.7 d，未见明显并发症，病理均为肾透明细胞癌。结论对于肾肿物合并输尿管结石，可以考虑行输尿管镜碎石取石术，根据肿物性质同期行后腹腔镜肾囊肿开窗或肾部分切除术，安全有效。
Abstract:
ObjectiveTo discuss the safety and feasibility of minimally invasive surgery for renal mass combined with ureteral calculi.MethodsA retrospective analysis was made on 11 cases of renal mass combined with ureteral calculi in our center from March 2011 to May 2018. There were 7 cases of left renal mass and 4 cases of right renal mass. For 5 cases of renal cysts, the diameter was 4.2-5.8 cm (mean, 4.9 cm). For 6 cases of renal cancer, the tumor diameter was 1.7-4.1 cm (mean, 2.4 cm). There were 9 cases of ipsilateral ureter calculi and 2 cases of contralateral ureter calculi. Retroperitoneal laparoscopic unroofing of renal cyst or partial nephrectomy was performed after ureteroscopic lithotripsy. ResultsUreteroscopic lithotripsy and retroperitoneal laparoscopic unroofing of renal cyst was performed in 5 cases. The operation time was 72-226 min (mean, 122.8 min). The blood loss was 5-10 ml, without blood transfusion. The postoperative hospitalization was 4-7 d (mean, 4.8 d). No obvious complications occurred. Pathological results showed renal cysts. Ureteroscopy lithotripsy and retroperitoneal laparoscopic partial nephrectomy was performed in 6 cases of renal cancer. The operation time was 158-314 min (mean, 220.3 min) and the blood loss was 20-100 ml (median, 20 ml), without blood transfusion. The postoperative hospital stay was 6-11 d (mean, 7.7 d). No obvious complications were seen. Pathological findings revealed clear cell renal carcinoma.ConclusionsUreteroscopic lithotripsy can be taken into consideration for patients with renal mass combined with ureteral calculi. Laparoscopic unroofing of renal cyst or partial nephrectomy can be performed simultaneously.

参考文献/References:

[1]Alatab S,Pourmand G,El Howairis Mel F,et al.National profiles of urinary calculi: a comparison between developing and developed worlds.Iran J Kidney Dis,2016,10(2):51-61.
[2]Bas O,Nalbant I,Can Sener N,et al.Management of renal cysts.JSLS,2015,19(1): e2014-e2097.
[3]Znaor A,LortetTieulent J,Laversanne M,et al.International variations and trends in renal cell carcinoma incidence and mortality.Eu Urol,2015,67(3):519-530.
[4]王宁，姚健，罗黔，等.后腹腔镜联合经皮肾碎石术同期治疗肾囊肿并复杂肾结石2例.中国微创外科杂志,2010,10(9):860-861.
[5]梁晓宇，叶向东，邹伟波，等.后腹腔镜肾囊肿去顶联合经皮肾穿刺碎石术在肾囊肿合并肾或输尿管上段结石患者中的应用研究.河北医学,2015，21(1):45-49.
[6]Hu X,Jiang K,Chen H,et al.Simultaneous treatment of renal and upper ureteral stone and cysts with percutaneous nephrolithotomy and cyst laser intrarenal incision and drainage.Urol J,2017,15(1):6-10.
[7]Chen H,Qi L,Zu X,et al.Percutaneous intrarenal cyst marsupialization and simultaneous nephrolithotomy in selected patients: killing two birds with one stone?Urology,2014,84(6): 1267-1271.
[8]张斌斌，强亚勇，郭巍，等.四种腔镜治疗输尿管上段直径>1 cm结石的疗效对比研究.中华泌尿外科杂志,2018,39(4):300-304.
[9]Wang Y,Zhong B,Yang X,et al.Comparison of the efficacy and safety of URSL,RPLU,and MPCNL for treatment of large upper impacted ureteral stones: a randomized controlled trial.BMC Urology,2017,17(1):50.
[10]Lee JY,Lee SW.Concomitant laparoendoscopic singlesite surgery for ureterolithotomy and contralateral renal cyst marsupialization.Korean J Urol,2011,52(1):64-67.

备注/Memo

备注/Memo:
＊通讯作者，Email：bysyzhaolei@163.com①(北京大学第三医院麻醉科，北京100191)②（黑龙江省绥化市第一医院泌尿外科，绥化152000）
更新日期/Last Update: 2019-03-01