経皮的腎尿管砕石術の臨床成績と結石再発率

Abstract

PNL開始後11年間の173例178腎の治療成績をまとめた.完全排石は61.8%, 4mm以下の残石は34.3%であった.PNL後半年以上経過し, 完全排石が確認された症例は105例であった.これらの累積再発率は1年4.2%, 3年16.6%, 5年29.2%, 7年34.4%, 10年55.4%であった.Risk factorで統計学的に有意なものはみられなかった

A total of 178 renal units in 173 patients with renal and upper ureteral calculi were treated by percutaneous nephrolithotripsy (PNL) between November 1984 and October 1995. PNL was performed as a monotherapy in 70 kidneys, while extracorporeal shock wave lithotripsy (ESWL) was combined in 108 kidneys. At the time discharged 110 (61.8%) kidneys were stone-free and the overall success rate, defined as no residual stone or fragments 6 months of follow-up, the cumulative stone recurrence rate was 4.2% at 1 year, 16.6% at 3 years, 29.2% at 5 years, 34.4% at 5 years and 55.4% at 10 years. None of the pretreatment parameters, such as stone size, number, location, composition, past history of urolithiasis and upper urinary tract obstruction, had a significant influence on stone recurrence.