腎サンゴ状結石の術後再発と予防

Abstract

Residual stone and stone recurrence following operation for renal staghorn calculus were investigated in 58 kidneys of 55 patients. Residual stones were found in 12 kidneys (20.7%), but cases who underwent intraoperative radiogram using Kodak X-O mat KS film or extracorporeal renal surgery showed no residual stones. True recurrence was observed in 9 kidneys (19.6%). The rates of true recurrence after partial nephrectomy, nephrolithotomy, extended pyelolithotomy and autotransplantation with extracorporeal renal surgery were 29.2%, 8.3%, 33.3% and 0% respectively. Morphological study of renal tissue removed intraoperatively from patients with staghorn calculus suggested that calcium deposits in pelvic mucosa or collecting tube might play an important role in stone recurrence. However, despite the calcium deposits in removed specimens, no recurrences have been observed in patients who underwent extracorporeal surgery for complicated staghorn calculus. Therefore, this procedure might be useful to prevent stone recurrence.