運用軟式輸尿管鏡及雙鏡聯合碎石術行結石治療之單一醫學中心經驗

陳韋辰¹、王樹吉¹、程千里¹、盧嘉文¹、陳卷書¹、李建儀¹、楊晨洸¹、王賢祥¹、陳正哲¹、林嘉彥¹、洪晟鈞¹、張瓈文¹、梅承恩¹、張家程¹、廖博崎¹、裘坤元¹

¹臺中榮民總醫院外科部 泌尿外科

Retrograde intrarenal surgery (RIRS) and Endoscopic combined intrarenal surgery (ECIRS) experience for stone management in a single center

 Wei-Cheng Chen, Shu-Chi Wang, Chen-Li Cheng, Kevin Lu, Chuan-Shu Chen, Jian‐Ri Lee, Cheng-Kuang Yang, Shian-Shiang Wang, Cheng-Che Chen, Chia-Yen Lin, Sheng-Chun Hung, Li-Wen Chang, Cheng-En Mei, Chia-Cheng Chang, Po-Chi Liao, Kun-Yuan Chiu

Divisions of Urology, Department of Surgery, Taichung Veterans General Hospital

Purpose:

Extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy (PCNL) used to be the mainstay for renal stone surgery. Recently, retrograde intrarenal surgery (RIRS) was introduced as another option for stone management in Taiwan. With RIRS and the instruments already in hand, the concept of endoscopic combined intrarenal surgery (ECIRS) was borned. Here we shared the experience of RIRS and ECIRS for stone mangement in our institute.

Materials and Methods:

From September 2018 to February 2019, there were 32 patients receiving retrograde intrarenal surgery (RIRS) for stone. Patient age ranging from 43 years old to 76 years old. Stone size were between 0.5cm to 3.5cm. Among them, 9 cases had renal stone bigger than 2cm in size. 11 cases had both renal stone and ureteral stone, and 3 cases received bilateral RIRS procedure. On the other hand, we underwent 2 ECIRS in 2020 in out institute.

Results:

For all 32 patients receiving RIRS procedure for stone, 21 of them achieved stone free status on the follow up image study. Both patients receiving ECIRS for renal stones achieved stone free, without perioperative complications.

Conclusion:

RIRS has been developing and is now a mature surgery in our institute. ECIRS is feasible and safe for complex renal stones. Greater stone free rated and surgical outcome could be expected with more experience. Further study is needed.