斜跨位一期行一侧经皮肾镜联合对侧输尿管镜治疗双侧上尿路结石的疗效分析

doi:10.3877/cma.j.issn.1674-3253.2019.05.004

中华腔镜泌尿外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (05) : 301 -303. doi: 10.3877/cma.j.issn.1674-3253.2019.05.004

所属专题：文献；

临床研究

斜跨位一期行一侧经皮肾镜联合对侧输尿管镜治疗双侧上尿路结石的疗效分析

刘成¹, 李卓航¹, 李奎庆¹, 刘皓¹, 许可慰¹^,^†(

)

^1. 510120　广州，中山大学孙逸仙纪念医院泌尿外科

收稿日期:2019-05-04 出版日期:2019-10-01
通信作者: 许可慰
基金资助:
国家自然科学基金资助项目(81572511、81702525); 广东省基础与应用基础研究专项自由申请项目(2016A030313317); 广东省科技计划项目(2013B021800105); 广州市科技计划项目(201803010029); 逸仙临床培育项目(sys-c-201802)

Obilque staddle position for one-stage surgery consisiting of pecutaneous nephroscopy on one side and ureteroscopy on the contralateral side

Cheng Liu¹, Zhuohang Li¹, Kuiqing Li¹, Hao Liu¹, Kewei Xu¹^,^†()

^1. Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China

Received:2019-05-04 Published:2019-10-01
Corresponding author: Kewei Xu
About author:
Correspongding author: Xu Kewei, Email: xukewei@mail.sysu.edu.cn

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引用本文：

刘成, 李卓航, 李奎庆, 刘皓, 许可慰. 斜跨位一期行一侧经皮肾镜联合对侧输尿管镜治疗双侧上尿路结石的疗效分析[J]. 中华腔镜泌尿外科杂志(电子版), 2019, 13(05): 301-303.

Cheng Liu, Zhuohang Li, Kuiqing Li, Hao Liu, Kewei Xu. Obilque staddle position for one-stage surgery consisiting of pecutaneous nephroscopy on one side and ureteroscopy on the contralateral side[J]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(05): 301-303.

目的

探讨斜跨位一期行一侧经皮肾镜和对侧输尿管硬/软镜治疗双侧上尿路结石的效果。

方法

回顾性分析我科2016年5月至2017年9月期间一期完成该术式双侧上尿路结石患者的临床资料。患者取经皮肾镜侧向上45°斜跨位，先行一侧输尿管硬/软镜，接着行对侧经皮肾镜，术后第1天复查血常规，术后1个月复查腹部平片（KUB）或超声。

结果

符合条件的患者共22例，21例患者顺利完成手术，1例患者因行经皮肾镜时出现无法忍受的胸痛而终止手术。术前结石大小为经皮肾镜侧（28.9±6.1，21.0～42.2）mm，输尿管硬/软镜侧（10.3±3.3，6.0～17.0）mm。平均手术时间（109±47，45～22.5）min，血红蛋白下降（1.8±1.6，0～6.0）g/dl。平均住院日（12±4，7～21）d。术中及术后无严重并发症发生。

结论

斜跨位是适合一期处理一侧经皮肾镜和对侧输尿管硬/软镜的理想体位。

关键词: 斜跨位, 双侧，上尿路结石, 经皮肾镜, 输尿管镜

Objective

To explore the efficacy and safety of one-stage percutaneous nephrolithotomy combined with contralateral ureteral rigid/flexible endoscopy in oblique straddle position for bilateral upper urinary tract calculi.

Methods

Clinical data of patients with calculi in bilateral upper urinary tract undergoing one-stage surgery from May 2016 to September 2017 were retrospectively analyzed. The patients were kept in a 45° straddle position during percutaneous nephroscopy. Firstly, rigid/flexible ureteroscopy was performed on one side, and then percutaneous nephroscopy was conducted on the contralateral side. Blood routine examination was performed at postoperative 1 d, and kidneys-ureters-bladder (KUB) radiograph or ultrasound was performed at 1 month after operation.

Results

Among 22 eligible patients, 21 patients successfully completed the surgery, and 1 patient terminated the operation due to unbearable chest pain during percutaneous nephroscopy. The preoperative stone size was measured as (28.9±6.1, 21.0-42.2) mm on the percutaneous nephroscopy side and (10.3±3.3, 6.0-17.0) mm on the rigid/flexible ureteroscopy side. The average operation time was (109±47, 45-225) min. The hemoglobin level was decreased by (1.8±1.6, 0-6.0) g/dL. The average length of hospital stay was (12±4, 7-21) d. No severe complications occurred during or after the surgery.

Conclusion

Oblique straddle position is an ideal position for one-stage surgery consisting of percutaneous nephroscopy on one side and rigid/flexible ureteroscopy on the contralateral side.

Key words: Oblique straddle position, Bilateral, upper urinary calculi, Percutaneous nephroscope, Ureteroscope

图1 斜跨位

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