Curative effect of percutaneous nephrolithoto my with holmiu mlaser lithotri psy in the treatment of medullary sponge kidney calculi
Song Chao
Li Jiuzhi
Wang Xue yi
Wen Bin
Luo Yong
Anni waer Yusufu
Yang Si xing
Abstract：To-evaluate-the-indication-,safety-and-efficacy-of-percutaneous-nephrolithotomy-(PCNL-)i-n-treati-ng-medullary-sponge-kidney-(MSK-).Methods-:By-usi-ng-the-hospital-information-system-(HIS-)databases-of-Renmin-Hospital-of-Wuhan-Uni-versity-and-Xi-njiang-People's-Hospital-,we-identified-and-retrospecti-vely-revie-wed-19-patients-(36-kidneys-)who-under-went-PCNL-for-MSK-bet-ween-Septe-mber-2005-and-Nove-mber-2013-.Patients-treated-with-other-methods-were-excl-uded-.Results-:Chronic-renal-fail-ure-(CRF-)was-recorded-i-n-8-cases-fro-m-19-patients-.-The-stone-burden-was-(21??4-±5??2-)mm-as-descri-bled-by-the-maxi-u-m-length-of-the-stones-.The-staged-surgery-was-prefor-med-on-17-bilateral-cases-with-one-sessi-on-for-each-ki-ndey-,including-9-kindeys-with-single-access-tract-,22-ki-d-neys-with-t-wo-access-tracts-and-10-with-three-tracts-.The-2-unilateral-cases-were-treated-with-t-wo-access-tracts-.The-percutaneous-renal-access-was-established-through-different-calices-,including-20-tracts-through-upper-calices-,36-tracts-through-mi-ddle-calices-and-10-through-lower-calices-.The-operative-time-of-our-cohort-was-(68??4-±15??1)mi-n-with-all-free-stones-of-all-patients-bei-ng-shattered-and-cleared??-The-postoperative-he-mogl-obi-n-was-reduced-by-(12??3-±5??7-)g/L-as-co-mpared-with-their-preoperative-counterpart-.No-transfusi-on-was-needed-i-n-this-series-.The-rate-of-u-ri-nary-infection-related-to-the-operati-on-was-10??5-%-(2/19-).No-kidney-l-ost-.No-pneu-mothorax-or-surroundi-ng-organ-injury-was-found-.All-19-cases-were-foll-o-wed-up-for-11??2-months-(range-fro-m-6-to-20-months-).Seven-cases-reported-the-history-of-spontaneous-discharge-of-the-resi-duary-stones-.The-ki-dey-function-i-n-8-cases-of-CRF-was-a-meli-orated-to-vari-ng-degrees-,1and-12-months-post-operati-on-.The-symptomssuch-as-l-u-mbodynia-,gross-he-maturia-and-uri-nary-tract-infection-were-si-gnificantly-a-meli-orated-,and-onl-y-21??1%-(4/19-)cases-co-mplai-ned-these-symptoms,but-the-frequency-was-reduced-dra-matically-after-PCNL-.Conclusions-:PCNL-was-a-safe-and-effective-treatment-for-MSK-based-on-its-effect-on-a-meli-orati-on-of-symptom,and-mai-ntai-nence-of-the-renal-function-.
Keywords：medullary sponge kidneyrenal caculipercutaneous nephrolithotomy
Publication Date：2014-01-01
Pages：6( 155-160 )