摘要
目的探讨一期微创手术治疗肾肿物合并输尿管结石的安全性和可行性。方法回顾性分析2011年3月～2018年5月同期治疗肾肿物合并结石11例资料。肾肿物左侧7例,右侧4例,5例肾囊肿长径4. 2～5. 8 cm,平均4. 9cm,6例肾实性肿瘤长径1. 7～4. 1 cm,平均2. 4 cm。输尿管结石9例与肾肿物同侧,2例为对侧。先行输尿管镜碎石取石术,再行后腹腔镜肾囊肿开窗或肾部分切除术。结果 5例肾囊肿行输尿管镜碎石取石+后腹腔镜肾囊肿开窗术,手术时间72～226 min,平均122. 8 min,出血量5～10 ml,无输血,术后住院时间4～7 d,平均4. 8 d,未见明显并发症,病理均为肾囊肿; 6例肾实性肿瘤行输尿管镜碎石取石+后腹腔镜肾部分切除术,手术时间158～314 min,平均220. 3 min,出血量20～100 ml,中位数20 ml,无输血,术后住院时间6～11 d,平均7. 7 d,未见明显并发症,病理均为肾透明细胞癌。结论对于肾肿物合并输尿管结石,可以考虑行输尿管镜碎石取石术,根据肿物性质同期行后腹腔镜肾囊肿开窗或肾部分切除术,安全有效。
Objective To discuss the safety and feasibility of minimally invasive surgery for renal mass combined with ureteral calculi. Methods A retrospective analysis was made on 11 eases of renal mass combined with ureteral calculi in our center from March 2011 to May 2018. There were 7 eases of left renal mass and 4 eases of right renal mass. For 5 eases of renal cysts, the diameter was 4.2-5.8 cm （mean, 4.9 cm）. For6 eases of renal cancer, the tumor diameter was 1.7-4.1 cm （mean, 2.4 cm）. There were 9 eases of ipsilateral ureter calculi and 2 eases of contralateral ureter calculi, Retroperitoneal laparoscopic unroofing of renal cyst or partial nephrectomy was performed after ureteroscopic lithotripsy. Results Ureteroscopic lithotripsy and retroperitoneal laparoscopic unroofing of renal cyst was performed in 5 cases. The operation time was 72 -226 min （mean, 122.8 min）. The blood loss was 5 - 10 ml, without blood transfusion. The postoperative hospitalization was 4 - 7 d （ mean, 4.8 d）. No obvious complications occurred. Pathological results showed renal cysts. Ureteroscopy lithotripsy and retroperitoneal laparoscopic partial nephrectomy was performed in 6 cases of renal cancer. The operation time was 158 -314 min （mean, 220.3 min） and the blood loss was 20 - 100 ml （median, 20 ml） , without blood transfusion. The postoperative hospital stay was 6 - 11 d （mean, 7.7 d）. No obvious complications were seen. Pathological findings revealed clear cell renal carcinoma. Conclusions Ureteroscopic lithotripsy can be taken into consideration for patients with renal mass combined with ureteral calculi. Laparoscopic unroofing of renal cyst or partial nephrectomy can be performed simultaneously.
作者
邱敏
宗亚楠
李焕荣
赵磊
卢剑
侯小飞
刘承
马潞林
Qiu Min;Zong Yanan;Li Huanrong(Department of Urology,Peking University Third Hospital,Beijing 100191,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2018年第11期1027-1029,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
肾肿瘤
输尿管结石
同期手术
Kidney neoplasms
Ureteral calculi
Simultaneous operations
