無術後管路之超迷你經皮腎造廔截石術：病例系列報告
方琬云、陳柏華、江恒杰、王百孚、張進寶、嚴孟意
彰化基督教醫院泌尿科
Totally Tubeless Super-mini Percutaneous Nephrolithotripsy procedure: A case series
Wan-Yun Fang, Pao-Hwa Chen, Heng-Chieh Chiang, Pai-Fu Wang, Chin-Pao Chang, Meng-Yi Yen
Department of Urology, Chunghwa Christian Hospital
Purpose:
Although being an invasive procedure, percutaneous nephrolithotripsy sometime is the only way for the patients with huge renal stones or staghorn stone. We share our experience of total tubeless super-mini percutaneous nephrolithotomy in selected patients.
Materials and Methods:
Since March, 2018, we performed three cases of super-mini percutaneous nephrolithotripsy. We used intra-operative C-arm guide “Eye of needle” technique to create the nephrostomy tract, and dilated the tract to 16 Fr. diameter using the Amplatz sequential dilator. A 16Fr. nephroscope and Holmiun laser (frequency: 12, power: 1200 Joules) were used to identify and fragment the stones. The wound was closed using 2-0 nylon and no nephrostomy tube nor double-J stent in place.
Results:
Average age was 63 years old, two male and one female. One case of bilateral renal stone and two cases of ipsilateral. Including renal pelvis stones, and 4 partial staghorn, the average size was 38.6mm x 21mm. Immediate stone free rate was obtained in all 3 patients. Average change of hematocrit was 6.3 g/dL. Hospital days were 3 days without complication.
Conclusion:
Even in cases of large burden renal stone, super-mini percutaneous nephrolithotripsy is a safe and efficient procedure without further discomfort of indwelling catheter.