経皮的腎尿管切石術103例の臨床成績と術後合併症

Abstract

1) 1984年9月よりPNLを施行した上部尿路結石症例のうち, 術後6ヵ月以上の長期に経過を観察しえた103例の臨床成績および合併症について検討した.2)全体の臨床的成功率は80.6%であったが, 後期33例の成功率は87.9%と満足しうる結果がえられ, UL-armを用いた腎瘻造設法の改善が一つの要因と考えられた.3)術後合併症では, 出血, 穿孔, 発熱の頻度が高かった.晩期合併症では, 2例に腎盂尿管移行部狭窄症を認めた.4)術後, 54例で定期的に血圧および血清レニン活性を測定したが, 術前に比べ有意な上昇は認めなかった

We report the results and complications of 103 consecutive patients who underwent percutaneous removal of renal and ureteral stones. The overall clinical success rate was 80.6%. For the recent 33 cases in which UL-arm fluoroscopy was used, however, the success rate was as high as 87.9%, which was considered to be due to easier establishment of percutaneous direct access. The most common complications were bleeding (18.5%), extravasation (15.5%) and fever (9.7%). Four cases with significant bleeding required arteriography, but there were no sign of arteriovenous fistula nor pseudoaneurysms in any cases. To study renal parenchymal damage in the percutaneous procedures, plasma renin activities (PRA) were compared in 54 cases after six months. However, significant elevation of PRA did not occur in any case.