腎結石に対する腎保存手術の検討

Abstract

A clinical study was carried out on 78 patients, 80 kidneys with renal calculi treated by conservative renal operation such as pyelolithotomy, extended pyelolithotomy, partial nephrectomy and nephrolithotomy from Jan. 1978 to Dec. 1979. Thirty-five residual calculi in 18 kidneys were noticed by postoperative X-ray (22.5%). These 80 kidneys with renal calculi were classified into 4 groups from the type of calculi and 4 groups from the type of renal collecting system to find out factors causing residual calculi. As to the type of calculi, the ratio of residual calculi was 52.4% in multiple calculi and 43.8% in complicated staghorn calculi. No residual calculi were noticed in single calculus or staghorn calculus. As to the type of renal collecting system, residual calculi were noticed in 10 kidneys with narrow pelvis, narrow calyceal neck and dilatated calyx (43.5%), and in 3 kidneys with dilatated pelvis, narrow calyceal neck and dilatated calyx (37.5%). In other two types residual calculi rate were 14.3% and 8.6%. These results indicated that factors causing residual calculi were the number of calculi and renal collecting system with narrow calyceal neck and dilatated calyx.