腹腔鏡下腎盂切石術を施行した馬蹄腎の1例

Abstract

A 66-year-oldwoman hada 22 mm right kidney stone accompaniedwith a horseshoe kidney. The size of this stone had been increasing gradually from 7 mm to 22 mm during the past 5 years. Although apparent pelviuretic junction stenosis couldnot be identifiedby intravenous urography, external pelvis was dilated in both kidneys. Complete excretion of fragmented stones by extracorporeal shockwave lithotripsy seemedto be difficult because impairedurinary passage from the renal pelvis to the ureter was suspected. Percutaneous nephrolithotomy was also difficult due to malrotation of the pelvic-caliceal system and possible interposition of bowel loops between kidney and abdominal wall. Therefore, we chose laparoscopic pyelolithotomy. This procedure made it possible to remove the stone completely with minimum invasiveness. We assume that laparoscopic pyelolithotomy is a safe andeffective approach for renal pelvic stone in case of horseshoe kidney.