改良经皮肾切除术治疗肾下垂:技术描述和短期效果

IF 0.9 4区 医学 Q4 UROLOGY & NEPHROLOGY Current Urology Pub Date : 2024-03-12 DOI:10.1097/cu9.0000000000000238
Honglei Liu, Wenzhi Gao, Zheng Zhang, Kun-lin Yang, C. Meng, Bing Wang, Yangjun Han, Mingxin Diao, C. Zuo, Minghua Zhang, Y. Diao, Zhihua Li, Xinfei Li, Gang Wang, Chunjiao Wang, Zihui Gao, Yaming Gu, Xuesong Li
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引用次数: 0

摘要

经皮肾穿刺术(PCN)已被证明是治疗肾下垂的可行方法。本研究介绍了一种改进的 PCN 技术,它能更好地解决肾下垂问题。 我们回顾了 2021 年 1 月至 2023 年 1 月间接受改进 PCN 手术的 4 位患者。这些患者被诊断为肾下垂,其中 1 例患者同时患有输尿管肾盂连接处狭窄和肾结石导致的肾下垂,3 例患者为单纯性肾下垂。研究人员收集了患者特征、围手术期数据和随访结果。手术成功与否取决于症状缓解程度(主观成功)和静脉肾盂造影显示肾脏无下坠(客观成功)。 术前计算机断层扫描尿路造影显示所有患者都有肾积水,其中重度肾积水占 75%(3/4),中度肾积水占 25%(1/4)。平均手术时间为 63.8 分钟(45-95 分钟不等),平均失血量为 5 毫升(5-50 毫升不等)。平均住院时间为 4.5 天(3-6 天不等)。拔除肾造瘘管的平均时间为 2 个月(1-4 个月)。术中和术后均未出现严重并发症(克拉维恩-丁多分级≥3)。术后血清肌酐平均水平为 54.75 μmoI/L(范围为 43-65 μmoI/L)。平均随访时间为 6.25 个月(范围为 4-8 个月)。客观和主观成功率均为 100%。 本研究中使用的改良 PCN 程序是可行的,为治疗肾下垂提供了一个很好的选择。
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Modified percutaneous nephropexy for nephroptosis: Technical description and short-term results
Percutaneous nephropexy (PCN) has been demonstrated as a feasible method for treating nephroptosis. This study describes an improved technique for PCN that better addresses the issue of nephroptosis. We reviewed 4 patients who underwent the improved PCN procedure between January 2021 and January 2023. These patients were diagnosed with nephroptosis, with 1 case having both a narrow ureteropelvic junction and nephroptosis due to a kidney stone, and 3 cases having simple nephroptosis. Patient characteristics, perioperative data, and follow-up results were collected. Surgical success was determined by symptom relief (subjective success) and the absence of kidney descent by intravenous pyelography (objective success). Preoperative computed tomography urography showed that all patients had hydronephrosis, with severe hydronephrosis in 75% (3/4) and moderate hydronephrosis in 25% (1/4) of cases. The mean operative time was 63.8 minutes (range, 45–95 minutes), and the mean blood loss was 5 mL (range, 5–50 mL). The mean length of hospital stay was 4.5 days (range, 3–6 days). The mean time to removal of the nephrostomy tube was 2 months (range, 1–4 months). No serious complications (Clavien-Dindo grade ≥3) occurred during or after the procedure. The mean postoperative serum creatinine level was 54.75 μmoI/L (range, 43–65 μmoI/L). The mean follow-up time was 6.25 months (range, 4–8 months). The objective and subjective success rates were both 100%. The improved PCN procedure that was used in this study is feasible and provides a good option for treating nephroptosis.
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来源期刊
Current Urology
Current Urology Medicine-Urology
CiteScore
2.30
自引率
0.00%
发文量
96
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