Objective To explore the safety and efficacy of percutaneous nephrolithotomy( PC-NL )with holminm laser lor the treatment ol renal transplant stones. Methods A retrospective review from 2008 to 2011 was performed in 5 cases of renal transplant stones treated with PCNL with holminm laser. Three cases were male and 2 cases were female;2 cases had multiple kidney stones and 3 cases had renal pelvic stones. The stone diameters ranged from 20 mm to 48 mm, and the post-trans plant at ion time ranged from 12 months to 12 years. All cases are first-time cadaveric renal transplantation. Results All 5 cases of surgery were successfully completed, including 4 cases of single-channel PCNL and 1 case of dual-channel PCNL. The operative time was 40 ~120 min with an average time of( 62±12 )min. No massive haemorrhage or septic shock occurred. Postoperative creatinine increased in 2 cases and then decreased to normal after 3 days. Four cases had moved the stones clearly, and one case had residual stones in the lower calyx of the transplanted kidney. One week later, the second PCNL was performed under local anesthesia, and postoperative KUB showed no residual stones. All cases were followed up for 24 months. No patient had stone recurrence,and the function of the transplanted kidney was normal. Conclusion In the treatment of renal transplant stones, PCNL with holmium laser has the characteristics of minimal invasion,little bleeding , prominent effect and high safety so that it is worthy of clinical application.%目的 探讨经皮肾镜钬激光碎石治疗移植肾结石的安全性及有效性.方法 回顾性分析我院2008年至2011年接受经皮肾镜钬激光碎石治疗的移植肾肾结石患者共5例,其中男性3例,女性2例;肾多发结石2例,肾盂结石3例.结石直径20～48mm,接受肾移植的时间1～12年,均是初次尸肾移植.结果 5例患者均顺利完成一期手术.单通道4例,双通道1例.手术时间40～120min,平均(62±12)min.5例患者均未出现大出血、感染性休克.2例术后肌酐一过性升高,3d后降至正常.4例结石一次取净,1例移植肾下盏结石残留,于一期术后1周在局麻下行二期经皮肾镜下取石,术后拍腹部平片未见明显结石残留.5例患者均随访24个月,未见结石复发,移植肾功能正常.结论 经皮肾镜钬激光治疗移植肾肾结石具有创伤小、出血少、效果好、安全性高等特点,值得临床推广应用.
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