Clinical Study of Laparoscopic Nephrolithotomy in Treatment of Complex Renal Calculi
Objective To explore the feasibility of laparoscopic non-atrophic nephrolithotomy(LANL)in the treatment of complex renal calculi.Methods The clinical data of 16 patients with LANL in our hospital from January 2017 to January 2023 were retrospectively analyzed.Preoperative CT plain scan+urinary tract imaging(CTU)were performed on all pa-tients to determine the number,size,shape,renal pelvis morphology,and degree of hydronephrosis of the stones.The pre-operative renal function of patients was recorded and compared with postoperative 24-hour renal function.Surgical time,in-traoperative renal artery clamping time,intraoperative bleeding,postoperative residual stone rate,and postoperative compli-cations were also recorded.Results All 16 surgeries were successful without any cases of conversion to open surgery.The average surgical time was(160.0±31.2)min;average renal warm ischemia time was(24.8±2.8)min;average intraopera-tive blood loss was(142±55)mL;duration of drainage tube placement postoperatively was(5.44±1.46)d,average length of hospital stay postoperatively was(7.50±0.89)d.Two patients had residual stones postoperatively,resulting in a stone clearance rate of 87.5%(14/16).There were no cases of urinary leakage,bleeding,or urosepsis.GFR levels in patients significantly increased at 1-month follow-up postoperatively compared to preoperative levels(P＜0.05).At a median follow-up of 17.75 months postoperatively,CTU showed a significant reduction in the degree of kidney obstruction in the patients.Conclusion Under the premise of appropriate screening of patients and rich experience in laparoscopic surgery,retroperito-neal LANL is a safe and effective minimally invasive method.Its high single-session stone clearance rate makes it particu-larly suitable for managing complex kidney stones that require single-session treatment.
LaparoscopyRenal parenchymal incision stoneKidney stoneCast stone
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