経皮的腎・尿管結石摘出術 - 1期的摘出術の経験

Abstract

1985年11月より1986年9月までに腎・尿管結石20例に対して21件の1期的結石摘出術を施行した.結石摘出率は100%であり, 微小結石の残石は3例(14%)に認められた.全例が1回または2回の操作で結石除去を完了した.重篤な合併症はなく, 本法は従来の観血的手術, 2期的経皮的結石摘出術に比べて優れた術式である.手術直後, 血清Na濃度は正常範囲ながら有意に低下し, 腎盂灌流液, 術中補液の改良が必要である

From November 1985 through September 1986, 20 cases of upper urinary tract calculi (14 kidney, 7 ureter) were treated by the one-stage procedure percutaneous nephrolithotripsy. Renal and ureteral calculi were successfully removed in all 20 cases (100%). After the procedure, a few small stone fragments remained in 3 cases (the rate of remnant stone : 14%). High fever was noted in 7 patients but did not last longer than 3 days. No patients required blood transfusion. The one-stage percutaneous procedure was considered a more efficient procedure to remove the upper urinary tract calculi, than open surgery or two stage percutaneous nephrolithotripsy. In one-stage percutaneous nephrolithotripsy, however, serum sodium concentration was lowered significantly after the procedure, although the hematocrit remained unchanged throughout. This should be carefully corrected by the supplement of irrigation fluid and intravenous infusion during the procedure.