經皮穿腎造廔截石術合併順逆向性輸尿管鏡碎石術對於腎結石合併上段輸尿管結石之分析
張賀翔、江博暉
高雄長庚紀念醫院 泌尿科
The outcome of percutaneous nephrolithotomy (PCNL) with antegrade or retrograde ureteroscopic lithotripsy for complicated renal stone with upper ureter stone
Chang Ho Hsiang, Chiang Po Hui
Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Taiwan
Purpose: The management of complicated renal stones with upper ureter stone still remains controversial. This study aims to compare the outcomes of percutaneous nephrolithotomy (PCNL) with antegrade ureteroscopic lithotripsy or PCNL with retrograde ureteroscopic lithotripsy for complicated renal stones with upper ureter stone.
Materials and Methods: This retrospective study was conducted from 2013 to 2017, a total of 57 patients received PCNL with antegrade ureteroscopic lithotripsy or retrograde ureteroscopic lithotripsy. The perioperative and postoperative data analysis included operative time, stone size, stone free rate, stone analysis, postoperative hospital stay, and complication.
Results:
A total of 57 patients underwent PCNL with antegrade ureteroscopic lithotripsy or retrograde ureteroscopic lithotripsy. The mean age was 57.4 years (range, 34.7-80.3 years), mean operative time was 91.6 minutes (range, 50-152 minutes), and mean postoperative hospital stay was 5.75 days (range, 3-7 days), respectively. No blood transfusion was recorded in our study. All patients received double J catheter placement smoothly. There were 9 cases of Clavien grade II complication. No major complication was recorded. The overall stone-free rate at three months was nearly 100%
Conclusions:
Our data demonstrate PCNL with antegrade or retrograde ureteroscopic lithotripsy is an effective and safe method for complicated renal stones with upper ureter stone.