迷你經皮腎取石術 – 高雄榮總初步經驗
金介文 蔡政諭 余家政
高雄榮民總醫院外科部泌尿外科
Minipercutaneous nephrolithotomy for renal stones: initial experience in Kaohsiung Veterans General Hospital
Chieh-wen Chin, Jeng-Yu Tsai, Chia-Cheng Yu
Divsion of Urology, Depart of Surgery, Kaohsiung Veterans General Hospital
Purpose:
For renal stone, miniPCNL was new treatment choice. The miniature nephroscopy offers a very slim, extremely easy-to-urs instrument for therapy of renal-plevis and caliceal stone. It provides minimum renal trauma during PCNL. Here we present our initial experience in minPCNL.
Materials and Methods:
A total of 11 patients (male: female=6:5) underwent mini-PCNL since 2016. Mean age was 56.5±11.5. Stone burden was 2.5±0.7 cm. Stone location (left: right=7:4) were renal pelvis with obstruction. Two stage PCNL was done. Wolf miniPCNL instrument (14.5F outer sheath, 6Fr working channel) was used. For lithotripsy, A 30W Ho-Yag Laser was used. Stone was removed along 16~18Fr Amplatz sheath with water flow and forceps.
Results:
Mean operative times were 145±52minutes. No serious complication was noted post operation. Blood loss was minimum. No patient received blood transfusion. Double J indwelling were done in 2 out 11 patients. Residual stones were noted in 2 patients and need further ESWL treatment. Mean hospital stay was 4.9±0.9 days.
Conclusion:
MiniPCNL technique need few learning curves. It provided few trauma to kidney and minimum blood loss during operation. Operative time were longer compare with traditional PCNL using ultrasound. But post-operative recovery was rapid than PCNL. For moderate stone burden within renal pelvis, miniPCNL was good treatment choice.