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中华腔镜外科杂志(电子版) ›› 2022, Vol. 15 ›› Issue (04) : 222 -226. doi: 10.3877/cma.j.issn.1674-6899.2022.04.007

论著

输尿管软镜处理大于3 cm肾结石的有效性和安全性评价
崔亮1,(), 付春龙1, 代晓飞1, 张讯1, 靖万林1, 孙晓俊1, 李景敏1   
  1. 1. 100123 北京,民航总医院泌尿外科
  • 收稿日期:2022-06-08 出版日期:2022-08-30
  • 通信作者: 崔亮
  • 基金资助:
    国家自然科学基金资助项目(面上项目)(51375494)

Evaluation of the efficacy and safety of flexible ureterorenoscopy in the treatment of renal calculi larger than 3 cm

Liang Cui1,(), Chunlong Fu1, Xiaofei Dai1, Xun Zhang1, Wanlin Jing1, Xiaojun Sun1, Jingmin Li1   

  1. 1. Urology Department of Civil Aviation General Hospital, Beijing 100123, China
  • Received:2022-06-08 Published:2022-08-30
  • Corresponding author: Liang Cui
引用本文:

崔亮, 付春龙, 代晓飞, 张讯, 靖万林, 孙晓俊, 李景敏. 输尿管软镜处理大于3 cm肾结石的有效性和安全性评价[J/OL]. 中华腔镜外科杂志(电子版), 2022, 15(04): 222-226.

Liang Cui, Chunlong Fu, Xiaofei Dai, Xun Zhang, Wanlin Jing, Xiaojun Sun, Jingmin Li. Evaluation of the efficacy and safety of flexible ureterorenoscopy in the treatment of renal calculi larger than 3 cm[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2022, 15(04): 222-226.

目的

探讨应用输尿管软镜(flexible ureterorenoscopy,FURS)处理直径>3 cm肾结石的有效性和安全性。

方法

回顾性分析2017年1月至2021年1月采用FURS下激光碎石取石术治疗直径>3 cm肾结石52例,其中单侧肾结石42例、双侧肾结石10例;下盏铸形结石24例、鹿角形结石5例,结石直径3.2~6.0 cm。所有患者均预留置单侧或双侧输尿管支架管至少10 d后行FURS手术。术后1 d及术后4周时行影像学(KUB)复查,评估碎石后效果。

结果

52例患者单次手术成功率100%,手术时间60~305 min,平均135.4 min;术后无发热,无严重并发症,术后1 d复查结石清除率86.5%,术后1个月复查结石清除率100%。

结论

对于熟练掌握FURS的中心,FURS单次手术治疗直径>3 cm的肾结石是一种相对安全、有效的临床方法。

Objective

To explore the feasibility and safety of flexible ureterorenoscopy(FURS) in the treatment of renal calculi larger than 3 cm and the surgical techniques in clinical practice.

Methods

52 cases of kidney stones larger than 3 cm in diameter were treated with FURS, including 42 cases of unilateral kidney calculi, 10 cases of bilateral kidney calculi, 24 cases of lower calyceal cast calculi, 5 cases of renal pelvis cast calculi with a stone diameter of 3.2-6.0 cm. FURS was performed in all patients after 10 days of unilateral or bilateral ureteral stent indwelling. KUB was performed on the first day and fourth week after operation to evaluate the effect of lithotripsy.

Results

The single operation success rate of 52 patients was 100%, the operation time was 60-305 min, and the average time was 135.4 min. there was no fever and serious complications after operation. The calculi clearance rate was 86.5% on the first day after operation, and 100% one month after operation.

Conclusions

For centers skilled in Furs, FURS is a relatively safe and effective clinical method for the treatment of kidney calculi larger than 3 cm.

图1 肾下盏铸形结石的处理技巧注:A.击打位置自结石近输尿管软镜处;B.逐渐向远处击打;C.击打过程中将已击碎结石冲出或取出;D.输尿管软镜绕过结石前端从侧方向远端击打;E、F.待铸形结石部分碎裂松动后,撤回输尿管软镜再次从近端结石处击打
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