背景:鹿角形结石(SC)占据肾盂和肾盏,常见于女性,与反复尿路感染(UTI)有关。明智的手术计划减少了由于肾SC而进一步损害肾脏的机会。开放结石手术(OSS)是通过一次手术干预清除此类巨大结石并保护肾脏免受持续功能损害的各种手术技术之一。
方法:一名47岁男性患者出现右侧肾绞痛,在进一步的调查中,他被诊断患有大肾结石,导致同侧肾功能严重受损。SC测量为8×4厘米,下部花萼中有另一块石头。薄薄壁组织,只有16%的相对函数。因此,我们选择了开放手术而不是侵入性较小的方法,因为在侵入性较小的选择中可能需要多次碎石术(ESWL).
结论:SCs,可以是完整的或部分的,常导致肾功能损害。因此,实施积极的治疗方法是至关重要的,包括彻底评估结石的大小和位置,病人的选择,和机构能力。优选完全消除SC以维持最大肾功能。基于临床,技术,和社会经济考虑,在讨论的病例中,选择开放肾盂切开取石术或OSS而不是经皮肾镜取石术进行SC切除。
结论:由于其独特的临床表现和病理异常,在一次开放性肾盂切开取石术中清除大结石的能力非常有效。
BACKGROUND: Staghorn calculi (SC) occupy the renal pelvis and calyces and are common in females linked to repeated urinary tract infections (UTIs). Judicious surgery planning reduces the chance of further damage to the kidney due to renal SCs. Open stone surgery (OSS) is one of the various operative techniques to remove such huge stones with one operative intervention and protect the kidney from ongoing functional damage.
METHODS: A 47-year-old male patient presented with right-sided renal colic pain, and on further investigations, he was diagnosed with a large renal stone responsible for substantial renal function impairment on the same side. The SC measured 8 × 4 cm with another stone in the lower calyx. thinner parenchyma, and only 16% relative function. Therefore, open surgery was selected over less invasive approaches because multiple lithotripsy (ESWL) sittings may have been required in less invasive options.
CONCLUSIONS: SCs, which can be complete or partial, often result in renal impairment. Hence, it is crucial to implement a proactive therapeutic approach that includes a thorough evaluation of the stone\'s size and position, the patient\'s choice, and institutional capacity. Complete elimination of SCs is preferred to maintain maximal renal function. Based on clinical, technical, and socioeconomic considerations, open pyelolithotomy or OSS was chosen over percutaneous nephrolithotomy for SC removal in the discussed case.
CONCLUSIONS: The ability to remove large stones in a single intervention with open pyelolithotomy has been very effective due to its distinctive clinical presentation and pathological abnormalities.