以腎臟對切取石術及體外震波碎石術處理結石併發術後尿滲囊腫－病例報告

一位55歲糖尿病患者，因左腎鹿角狀結石入院接受治療。經過腎臟對切取石術併用體外震波碎石術後，因結石街引起尿路阻塞，導致腎破裂及腎周圍尿液滲漏，在使用輸尿管鏡取石術及尿液引流和投與抗生素一段時間後，病人始告痊癒。由於合併使用開刀腎臟取石術及體外震波碎石術治療腎鹿角狀結石，其安全間隔須時多久，並無定論，特此提出報告，並進一步討論處理這類病人須注意之項。

關鍵字

腎臟對切取石術；體外震波碎石術；結石街；尿滲囊腫

並列摘要

A 55-year-old man wlth left renal staghorn stone was treated firstly by bisection nephroiithotomy and subsequent extracorporeal shock wave lithotripsy for residual fragments. A huge perirenal urinoma developed and demonstrate bv renosonography and antegrade pyelography on the 41 st dav postoperatively as a result ot inadequate renal parenchymal healing following previous operation and urinarv tract obstruction secondary to stone street format on aftPr ESWL treatment. Having institurted internal and percutaneous routes for urinary diversion and covered infection with parenteral antibiotics, the urinoma subsided promptly. This case gives rise to a question of after receiving bisection nephrolithotomy, what time interval should be skipped before undertaking any procedure with potential hazard of urinary tract obstruction and urinary leakage. It has been our belief that, in normal dindividual, one month is sufficient for tissue regeneration and therefore allowing for further adjuvant or ancillary treatment. However, the optimal time schedule remains skeptical especially in cases suspicious of having poor DM control, prolonged bed ridden and malnutritional status. Further investigation is requisite before drawing to any firm conclusion on this topic.

並列關鍵字

bisection nephrolithotomy ； extracorporeal shock wave-lithotripsy ； stone street ； urinoma

國際替代計量

以腎臟對切取石術及體外震波碎石術處理結石併發術後尿滲囊腫－病例報告

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