경피적 신쇄석술 54례

Abstract

We have performed percutaneous extraction of renal and upper ureter stones in 54 cases with use of the Storz percutaneous universal nephroscope(26Fr). With the patient under general anesthesia, a percutaneous tract was dilated up to 24Fr and the stone was immediately removed at one session. A variety of grasping and fragmentation techniques under fluoroscopic and endoscopic control were used to extract stones. Overall success rate was 65%. With increasing proficiency from accumulation of experience, rate of stone extraction has been increasing from 40% early in the series to 83% in the most recent cases. The advantage of this technique is that only 1 to 2cm skin incision is required to remove the stone with minimal postoperative morbidity, rapid convalescence, and sooner return to work. We conclude that percutaneous nephrolithotripsy appears to be an appropriate alternative to an open operation in most patients with symptomatic urolithiasis.