Phẫu thuật lấy sỏi thận qua da đường hầm nhỏ với phương pháp chọc dò không đặt thông niệu quản trên thận ứ nước=Ultrasound-guided mini percutaneous nephrolithotomy without indwelling ureteral catheter in dilated renal systems

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Tác giả: Anh Toàn Đỗ, Công Hậu Nguyễn, Thái Hoàng Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.436-442

Bộ sưu tập: Metadata

ID: 245879

Thêm vào giỏ

Nghiên cứu này đánh giá tính an toàn và hiệu quả của lấy sỏi thận qua da đường hầm nhỏ với phương pháp chọc dò dưới hướng dẫn siêu âm không đặt thông niệu quản trên thận ứ nước. Đối tượng, phương pháp: Nghiên hồi cứu trên 40 bệnh nhân thực hiện lấy sỏi thận qua da đường hầm nhỏ với phương pháp chọc dò không đặt thông niệu quản trên thận ứ nước từ tháng 9/2023-12/2023. Đánh giá kết quả bao gồm tỉ lệ sạch sỏi, các thông số trong lúc phẫu thuật, biến chứng sau mổ và tỉ lệ phải điều trị bổ sung. Kết quả: Độ tuổi trung bình là 53,2 và nam chiếm 42,5%. Gánh nặng sỏi trung bình là 529 mm2 và 77,5% tổng số bệnh nhân có thận ứ nước từ độ 2 trở lên. Với 92,5% bệnh nhân chỉ cần từ 1-2 lần chọc kim vào thận. Thời gian chọc dò để tiếp cận thận trung bình, thời gian phẫu thuật trung bình và thời gian hậu phẫu lần lượt là 191,75 giây, 77,75 phút và 4,15 ngày. Tỷ lệ sạch sỏi hoàn toàn là 85%. Các biến chứng xảy ra ở 7 bệnh nhân chỉ giới hạn nặng nhất ở độ IIIa theo phân loại Clavien- Dindo. Bốn bệnh nhân phải điều trị bổ sung. Kết luận: Lấy sỏi thận qua da đường hầm nhỏ với phương pháp chọc dò không đặt thông niệu quản trên thận ứ nước là phương án cho thấy an toàn và hiệu quả đối với sỏi thận. Giảm đáng kể thời gian phẫu thuật và tránh được những biến chứng không đáng có do thủ thuật đặt thông niệu quản gây ra.This study was to evaluate the safety and efficacy of ultrasoundguided mini percutaneous nephrolithotomy (US – guided mPCNL) without indwelling ureteral catheter in dilated renal systems for kidney stones. Subject and methods: This retrospective study included 40 patients underwent mPCNL with US – guided mPCNL) without indwelling ureteral catheter in dilated renal systems from September 2023 to December 2023. The outcomes included the rate of complete stone clearance, operative characteristics, postoperative complications, and the need for an additional procedure. Results: Median age was 53,2 years and males were 42,5 %. Median stone burden was 529 mm2 and 77,5% of all patients had hydronephrosis of grade 2 or higher. For 92,5 % of all patients only required 1-2 puncture. Median access duration, operative duration and hospital length of stay were 191,75 seconds, 77,75 minutes and 4,15 days. Complete stone clearance rate was 85%. Complications occurring in 7 patients were limited to the most severe level IIIa according to the Clavien-Dindo classification. Four patients required an additional procedure. Conclusions: US – guided mPCNL without indwelling ureteral catheter in dilated renal systems is safe and effective for kidney stones. This method significantly reduces surgical time and avoids unnecessary complications caused by ureteral catheterization procedures.

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