Laparoscopic Stone Surgery With the Aid of Flexible Nephroscopy
정재헌, 정창욱, 민선호, 오승준, 김현회, 조성용, 정현, 손환철, 이승배, 우승효, 김대경,
소속 상세정보
정재헌 ( Jung Jae-Hyun )
Seoul National University Hospital Department of Urology
정창욱 ( Jeong Chang-Wook )
Seoul National University Hospital Department of Urology
민선호 ( Min Sun-Ho )
Seoul National University Hospital Department of Urology
오승준 ( Oh Seung-June )
Seoul National University Hospital Department of Urology
김현회 ( Kim Hyeon-Hoe )
Seoul National University Hospital Department of Urology
조성용 ( Cho Sung-Yong )
SMG-SNU Boramae Medical Center Department of Urology
정현 ( Jeong Hyeon )
SMG-SNU Boramae Medical Center Department of Urology
손환철 ( Son Hwan-Cheol )
SMG-SNU Boramae Medical Center Department of Urology
이승배 ( Lee Seung-Bae )
SMG-SNU Boramae Medical Center Department of Urology
우승효 ( Woo Seung-Hyo )
Eulji University School of Medicine Department of Urology
김대경 ( Kim Dae-Kyung )
Eulji University School of Medicine Department of Urology
KMID : 0358320140550070475
Abstract
Purpose: To report the outcome of laparoscopic pyelo- and ureterolithotomies with the aid of flexible nephroscopy.
Materials and Methods: A retrospective analysis was performed in 71 patients with complex renal stones or large and impacted proximal ureteral stones. Patients underwent laparoscopic pyelo- or ureterolithotomies with or without the removal of small residual stones by use of flexible nephroscopy between July 2005 and July 2010. Operative success was defined as no residual stones in the intravenous pyelogram at 12 weeks postoperatively. Perioperative results and surgical outcomes were analyzed.
Results: The patients’ mean age was 54.7±13.7 years, and 53 males (74.6%) and 18 females (25.4%) were included. The mean maximal stone size was 19.4±9.4 mm. A total of 47 cases were complex renal stones and 24 cases were impacted ureteral stones. Mean operative time was 139.0±63.7 minutes. Stones were completely removed in 61 cases (85.9%), and no further ancillary treatment was needed for clinically insignificant residual fragments in 7 cases (9.9%). For complex renal stones, the complete stone-free rate and clinically significant stone-free rate were 80.9% and 93.6%, respectively. Multivariate analysis showed that the use of flexible nephroscopy for complex renal stones can reduce the risk of residual stones. A major complication occurred in one case, in which open conversion was performed.
Conclusions: Laparoscopic stone surgery is a safe and minimally invasive procedure with a high success rate, especially with the aid of flexible nephroscopy, and is not associated with procedure-specific complications.
키워드
Cystoscopes;Kidney calculi;Laparoscopes;Ureteral calculi
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