[1]刘亮程* 曹贵华 黄贵闽 杜建平 李伟 董丽佳 李强.经皮输尿管镜治疗同侧肾囊肿合并肾结石疗效分析[J].中国微创外科杂志,2020,01(11):1046-1049.
　Liu Liangcheng,Cao Guihua,Huang Guimin,et al.Efficacy of Percutaneous Endoscopic Surgery for Simultaneous Treatment of Renal Cysts and Stones[J].Chinese Journal of Minimally Invasive Surgery,2020,01(11):1046-1049.
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经皮输尿管镜治疗同侧肾囊肿合并肾结石疗效分析()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2020年11期
页码:
1046-1049
栏目:
经验交流
出版日期:
2020-11-25

文章信息/Info

Title:
Efficacy of Percutaneous Endoscopic Surgery for Simultaneous Treatment of Renal Cysts and Stones
作者:
刘亮程* 曹贵华 黄贵闽 杜建平 李伟 董丽佳 李强
（四川省乐山市人民医院泌尿外科，乐山614000）
Author(s):
Liu Liangcheng;  Cao Guihua;  Huang Guimin;  et al.
Department of Urology, Leshan People’s Hospital, Leshan 614000, China
关键词:
经皮内镜手术; 肾囊肿; 肾结石
Keywords:
Percutaneous endoscopic surgery; Renal cyst; Renal calculus
文献标志码:
B
摘要:
目的探讨经皮输尿管镜激光治疗同侧肾囊肿合并肾结石的安全性和有效性。方法回顾性分析2018年7月~2019年10月增强CT确诊为肾囊肿合并同侧肾结石25例的临床资料。肾囊肿直径4.2~7.6 cm，平均5.7 cm，其中肾盂旁囊肿6例，单纯性肾囊肿19例；结石横截面积210~884.7 mm2，平均400.0 mm2。对背侧肾囊肿，在超声引导下经皮穿刺至肾囊肿腔内，建立F20通道。输尿管镜下用鞘分离囊肿壁与肾周脂肪组织。用钬激光（60 W）切除囊壁并送检，囊肿腔内留多孔引流管。超声引导下建立F18通道，输尿管镜下钬激光(60 W)碎石，留置双J管及F14肾造瘘管。观察围手术期并发症、术后住院时间及手术效果。结果2例腹侧肾囊肿术中未找到，23例肾囊肿和25例肾结石成功处理。无活动性出血、尿漏、肾实质或邻近脏器损伤等并发症。术后随访3个月，16例囊肿完全消失，5例囊肿体积较术前减小>50%，2例囊肿复发，肾囊肿手术有效率84%(21/25)；结石一期清除率88%（22/25）。结论经皮输尿管镜处理肾结石合并背侧、肾盂旁囊肿安全、有效、微创。
Abstract:
ObjectiveTo determine the safety and efficacy of a novel technology referred to percutaneous ureteroscopic laser for simultaneous treatment of renal cysts and stones.MethodsFrom July 2018 to October 2019, 25 patients having surgical indications with renal cysts and stones evaluated by enhanced CT scanning were enrolled. The mean diameter of cyst was 5.7 cm (range, 4.2-7.6 cm). There were 6 patients suffered with parapelvic cysts and 19 patients suffered with simple renal cyst. The mean stone crosssectional area was 400.0 mm2 (range, 210-884.7 mm2). Under the guidance of ultrasound, percutaneous puncture was performed into the renal cyst cavity to establish F20 channel. The cyst wall and perirenal adipose tissue were separated by the sheath under ureteroscope. Holmium laser (60 W) was used to resect the cyst wall and send it for examination. Multihole drainage tube was left in the cyst cavity. Under the guidance of ultrasound, F18 channel was established, holmium laser (60 W) lithotripsy under ureteroscope was carried out, and a double J tube and a F14 nephrostomy tube were indwelled. The perioperative complications, postoperative hospital stay and operation effect were observed. ResultsTwo cases of ventral renal cysts were not found during operation, and 23 cases of renal cysts and 25 cases of stones were successfully treated. There were no active bleeding, urinary leakage, renal parenchyma or adjacent organ injury or other complications. After 3 months of followups, 16 cases of cysts completely disappeared, 5 cases of cyst volume decreased more than 50%, and 2 cases of cyst recurrence were identified. The renal cyst surgery effective rate was 84% (21/25), and the stone clearance rate was 88% (22/25). ConclusionPercutaneous ureteroscopy is safe, effective and minimally invasive in the treatment of dorsal and parapelvic cysts with renal calculi.

参考文献/References:

[1]中华医学会泌尿外科学分会结石学组，中国泌尿系结石联盟.经皮肾镜取石术中国专家共识.中华泌尿外科杂志,2020,41(6)：401-404.
[2]胡嘏,杨俊,夏丁,等.经皮输尿管镜激光肾囊肿去顶术治疗肾囊肿的安全性和有效性.中华泌尿外科杂志,2017,38(1):1-4.
[3]万胜红,徐德强,阮建中,等.经囊肿穿刺肾盏的方法同期治疗肾囊肿和肾结石.现代泌尿外科杂志,2019,24(1):55-57.
[4]Zewu Z,Hequn C,Yu C,et al.Longterm outcome after flexible ureteroscopy with holmium laser for simultaneous treatment of a single renal cyst and ipsilateral renal stones.J Int Med Res,2019,47(8):3601-3612.
[5]Huang G,Cao G,Du J,et al.Percutaneous approach in the treatment of renal cyst with ipsilateral renal stones.Videourology,2020,https:∥www.liebertpub.com/doi/10.1089/vid.2020.0034.
[6]Hamedanchi S,Tehranchi A.Percutaneous decortication of cystic renal disease.Korean J Urol,2011,52(10)：693-697.
[7]彭国辉,李汉忠,李秉诚,等.SHA.LIN、S.T.O.N.E评分系统和Guy’s分级法预测经皮肾镜取石术结石清除率准确性的比较研究.中华泌尿外科杂志,2016,37(3):199-205.
[8]高健刚,孙小庆,侯四川,等.肾盂旁囊肿的后腹腔镜手术选择(附39例告).临床泌尿外科杂志,2012,27(11)：807-808.
[9]Basiri A，Hosseim SR，Tousi VN，et al．Ureteroscopic management of symptomatic，simple parapelvic renal cyst．J Endourol，2010,24(4)：537-540．
[10]Agarwal MM,Hemal AK.Surgical management of renal cystic disease．Curr Urol Rep，2011，12(1)：3-10．
[11]庞桂建，刘成倍，徐伟，等.腹腔镜下肾囊肿去顶减压同期直视下微创经皮肾镜取石术治疗肾结石合并肾囊肿.中国内镜杂志,2013,19(4)：431-433.
[12]闫昆吾,刘文瞻,孟娜,等.超声引导输尿管软镜钬激光切开内引流术治疗肾盂旁囊肿.中国微创外科杂志,2019,19(5)：412-414.
[13]Bach T，Herrmann TR,Ganzer R,et al.RevoLix vaporesection of the prostate: initial results of 54 patients with a 1year followup.World J Urol,2007,25(3):257-262.

备注/Memo

备注/Memo:
*通讯作者，Email：872291308@qq.com
更新日期/Last Update: 2021-02-07