输尿管软镜技术治疗肾结石合并同侧肾囊肿的临床体会

Clinical experience of the treatment of renal calculi complicated with renal cyst under flexible ureteroscope

摘要:

目的 探讨输尿管软镜下钬激光碎石联合囊肿内切开引流手术处理肾结石合并同侧肾囊肿的临床价值及经验。方法 选取2013年7月－2018年7月该科收治的、符合入选标准的肾结石合并同侧肾囊肿患者37例，随机分为研究组与对照组，研究组患者采用输尿管软镜下钬激光碎石联合囊肿内切开引流手术，对照组患者先行输尿管软镜下钬激光碎石手术，再行后腹腔镜下肾囊肿去顶减压手术。对手术时间、总住院时间、手术并发症发生率、术后残石率及术后1年囊肿复发率等进行统计学分析。结果 研究组在手术时间和总住院时间方面明显优于对照组，差异均有统计学意义（P < 0.05），而两组在手术并发症发生率、术后残石率及术后1年囊肿复发率方面比较，差异均无统计学意义（P > 0.05）。结论 输尿管软镜下钬激光碎石联合囊肿内切开引流术在肾结石合并同侧肾囊肿的临床治疗中具有优势，值得推广。

Abstract:

Objective To investigate the clinical value and experience of holmium laser lithotripsy combined with cyst internal incision and drainage under flexible ureteroscope in treatment of renal calculi complicated with ipsilateral renal cyst.Methods From July 2013 to July 2018, 37 patients with renal calculi complicated with ipsilateral renal cyst who met the selection criteria were selected. All the patients were randomly divided into study group and control group. Patients in the study group were treated with holmium laser lithotripsy combined with cyst internal incision and drainage under flexible ureteroscope. Patients in the control group were treated with holmium laser lithotripsy under flexible ureteroscope first, and then underwent retroperitoneal laparoscopic renal cyst unroofing and decompression. Statistical analysis and comparison were made on the data of operation time, total hospitalization days, incidence of surgical complications, postoperative residual stone rate and cyst recurrence rate one year after operation.Results The study group was better than the control group in the operation time and total hospitalization days (P < 0.05), but there was no significant difference in the occurrence of operation complications, the rate of postoperative residual stones and the rate of cyst recurrence one year after operation (P > 0.05).Conclusion Holmium laser lithotripsy combined with cyst internal incision and drainage under flexible ureteroscope has advantages in the clinical treatment of renal calculi complicated ipsilateral renal cyst, which is worth popularizing.