迷你經皮腎取石術治療2.5公分結石
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 large than 2.5 cm
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-pelvis and caliceal stone. It provides minimum renal trauma during PCNL. Here we present our initial experience in minPCNL.
Materials and Methods:
A total of 40 patients (male: female=27:13) underwent mini-PCNL since 2016. Stone location (left: right=21:19) were renal pelvis with obstruction. Mean age was 57±9. Mean stone burden was 2.5±0.7 cm. Stone burden more than 2.5 cm was 15 cases. 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 100±52 minutes. No serious complication was noted post operation. Blood loss was minimum. No patient received blood transfusion. Mean hospital stay was 4.3±0.9 days. Stone treatment had shift from traditional PCNL to miniPCNL after more experience on stone management and removal.
Conclusion:
MiniPCNL technique needs few learning curves. It provided few trauma to kidney and minimum blood loss during operation. Operative time is longer comparing with traditional PCNL using ultrasound. But post-operative recovery was rapid than PCNL. For moderate stone burden within renal pelvis, miniPCNL was a good treatment choice.