微创经皮肾镜取石术联合输尿管软镜治疗复杂性肾结石临床系列研究
|
摘要
第一章单通道微创经皮肾镜取石术联合二期输尿管软镜治疗复杂性肾结石
目的：探讨单通道微创经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石的有效性及安全性。
方法：自2011年1月至2012年2月采用“一期单通道微创经皮肾镜取石术、二期截石斜仰卧位下联合逆行输尿管软镜碎石取石术”治疗方法79例复杂性肾结石患者,其中左侧肾结石40例,右侧肾结石32例,双侧肾结石7例；铸型肾结石25例,肾多发结石54例,结石直径1.2-4.8cm,功能性孤立肾24例,血肌酐及尿素氮有不同程度升高的31例。16例有开放取石病史,合并高血压病21例,糖尿病12例,泌尿系感染33例。
结果：所有手术均成功建立20F工作通道并行一期经皮肾镜碎石取石,一期手术时间32-176min,平均(85+16)min。术后第2天复查KUB,中盏结石残留21例,上盏结石残留13例,下盏结石残留12例,多发结石残留33例。术后第3-5天行二期逆行输尿管软镜取石术,术中均可探及结石,采用钬激光碎石治疗,其中68例联合应用套石蓝套取结石至肾盂内,经原经皮肾工作通道进行碎石取石,二期手术时间18-134min,平均(46±21)min,二期结石清除率为92.4%(73/79)。6例结石残留患者行术后1月行体外冲击波碎石治疗,4例碎石后结石完全排出,2例残留结石直径均小于1.Ocm。未出现气胸、肠道损伤及大出血等严重并发症。随访时间1～13月,残留结石未见移位,未引起梗阻。
结论：单通道经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石有利于减少手术并发症并提高结石清除率,方法安全、有效,值得临床推广。
第二章微创经皮肾镜取石术一期联合输尿管软镜治疗复杂性肾结石
目的：探讨微创经皮肾镜取石术一期联合逆行输尿管软镜治疗复杂性肾结石的有效性及安全性。
方法：自2012年1月至2012年12月,采用微创经皮肾镜取石术一期联合逆行输尿管软镜治疗复杂性肾结石62例。其中左侧肾结石29例,右侧肾结石33例,完全性铸型结石17例,不完全性铸型结石31例,多发性结石14例,直径2.1-4.9cm。13例患侧肾脏有开放取石病史,合并高血压病8例,糖尿病7例,泌尿系感染16例。首先建立经皮肾镜工作通道并一期碎石取石,应用微创肾镜取出所能探及的所有结石后,C臂X线机透视检查残留结石,若残留结石直径大于20mm,采用多通道取石,穿刺结石所在肾盏并建立经皮肾镜通道,取出结石；对于残留结石直径小于20mm的,采用逆行输尿管软镜取石。
结果：所有手术均成功建立经皮肾镜工作通道并一期碎石取石,其中单通道取石46例,双通道取石16例。经皮肾镜取石术后残留上盏结石残留14例,中盏结石残留21例,下盏结石残留12例,多发结石残留15例。62例患者中,3例应用输尿管软镜无法探及结石,余59例逆行输尿管软镜均探及残留结石并采用钬激光碎石治疗。47例联合应用套石蓝套取结石至肾盂内,经原经皮肾工作通道进行碎石取石。平均手术时间(125±18)min,术后第2天结石清除为72.6%(45/62),术后1月结石清除率为91.9%(57/62)。未出现气胸、肠道损伤、大出血或尿源性脓毒血症等严重并发症。
结论：微创经皮肾镜取石术一期联合逆行输尿管软镜治疗铸型肾结石安全、有效,值得临床推广。
第三章单通道微创经皮肾镜取石术联合二期逆行输尿管软镜治疗孤立肾铸型结石
目的：探讨分期单通道微创经皮肾镜取石术联合逆行输尿管软镜治疗孤立肾铸型结石的有效性及安全性。
方法：回顾性分析2007年4月份至2010年3月份应用微创经皮肾镜取石术及输尿管软镜钬激光碎石手术治疗孤立肾合并铸型结石患者24例。24例孤立肾患者中,先天性孤立肾2例,对侧肾切除5例,对侧肾脏无功能17例。完全性铸型结石16例(66.7%),不完全性铸型结石8例(33.3%),结石平均表面积1501.8±899.7mm2(512-5630mm2)。术前平均血肌酐1.7±0.8mg/dl(0.5-4.9mg/d1),11例患者术前血肌酐大于1.4mg/dl。合并高血压病4例,糖尿病3例,泌尿系感染11例。
手术均由同一泌尿外科医师进行操作,微创经皮肾镜取石通道限制为单通道。建立20F微创经皮肾取石通道,F12李逊微创肾镜经工作通道进入肾集合系统,应用气压弹道碎石器或钬激光击碎结石,利用鳄鱼嘴钳取出较大结石,小结石可通过微创肾镜连接负压吸引器吸出。术毕保留输尿管外支架管及肾造瘘管,一期术后3-5天,肾造瘘管引流液转清后行二期手术治疗。二期手术操作中,患者取截石斜仰卧位,输尿管置入12F输尿管软镜工作鞘,7.2F的输尿管软镜经工作鞘进入肾集合系统内寻找结石后并应用200um钬激光碎石,较大结石应用套石篮套取结石至肾盂内,经原经皮肾取石通道碎石并取出。
结果：本组病例中,2例患者一期单通道微创经皮肾取石术取净结石,余22例患者均行二联合输尿管软镜取石。22例结石残留患者,一期微创经皮肾镜取石术后平均结石表面积降至235.8±353.3mm2。微创经皮肾镜取石平均手术时间64.2±25.5min(32-180min),二期联合逆行输尿管软镜手术时间116.2±33min (24-173min)。二期术后总结石清除率83.3%,仅4例术后结石残留。术中及术后无明显的手术并发症发生,平均血红蛋白浓度下降1.1-3.7g/dl。3例患者需要输血治疗,其中有2例合并术前贫血。一期术后发热患者4例,均经抗炎治疗后缓解。本组平均随访时间21.3±3.2月(9-38月),平均血肌酐水平从术前1.7±0.8mg/dl下降至术后1.3±0.4mg/dl(P<0.05)。术前11例肾功能不全患者中,4例术后肌酐降至正常水平,7例患者肌酐水平稳定在1.4-2.7mg/dl之间,没在患者肾功能明显恶化或需要血透治疗。
结论：单通道经皮肾镜取石术联合逆行输尿管软镜治疗孤立肾铸型结石安全、有效,值得临床推广。
第四章CT三维重建在微创经皮肾镜取石联合输尿管软镜处理肾结石中的应用
目的：探讨CT三维重建在微创经皮肾镜取石术联合输尿管软镜处理肾结石中的应用价值。
方法：自2012年1月至2012年8月,对微创单通道经皮肾镜取石术后残留结石42例患者行上尿路CT三维重建,充分了解肾脏集合系统结构、结石分布及结石与肾盂肾盏间的关系,测量结石所在肾盏长轴与经皮肾造瘘通道及肾盂间的夹角,指导二期输尿管软镜处理结石。
结果：CT发现单发肾结石17例,多发肾结石25例,结石直径0.4-2.1cm。测得结石所在肾盏长轴与肾盂长轴间的夹角为8-207°,平均夹角870；结石所在肾盏长轴与经皮肾造瘘通道的夹角为0-1350,平均夹角43°。选取夹角较大的通道作为输尿管软镜入镜路径。所有患者术中均可探及结石,采用钬激光碎石治疗,经输尿管工作鞘软镜取石34例次,经皮肾造瘘通道输尿管软镜取石14例次。手术时间16-112min,平均(52+11)min,结石清除率为95.2%(40/42),2例结石残留直径均小于1cm。本组无改开放手术病例,未出现感染性休克、气胸及大出血等严重并发症。
结论：上尿路CT三维重建可形象直观地显示肾脏的解剖结构及与结石间的关系,有助于指导输尿管软镜寻找结石、减少手术时间并提高结石清除率和手术安全性。
第五章多通道微创经皮肾镜取石术与单通道微创经皮肾镜取石术联合输尿管软镜治疗复杂性肾结石的对比研究
目的：比较多通道微创经皮肾镜取石术与单通道微创经皮肾镜取石术联合输尿管软镜治疗复杂性肾结石的临床疗效。
方法：选取本单位应用单通道微创经皮肾镜取石术后肾结石残留患者进行手术治疗,要求残留结石为多发,且单个结石直径≤2cm。2012年3月至2012年12月32例患者入选本组资料,其中男19例,女13例,平均年龄45.6±10.5岁(21-69岁)。32例患者随机分为A组和B组,每组各16例,A组采用多通道微创经皮肾取石,B组在原微创经皮肾镜取石通道的基础上联合逆行输尿管软镜进行取石。两组二期手术操作均在一期术后第3-5天肾造瘘管引流液变清后进行。分析对比两组资料的手术时间、血红蛋白浓度下降值、结石清除率、住院时间及术前后的血肌酐变化。
结果：所有手术均成功探及结石并进行碎石取石,无大出血、败血症、邻近脏器损伤等严重并发症发生。A组二期新建立通道1-3个,平均1.4个。A组和B组的平均手术时间分别为59.6+22.5min和63±24.8min,差异无统计学意义(P>0.05)。A平均血红蛋白浓度下降0.83±0.76g/dl,血红蛋白浓度下降高于B组0.35±0.47g/dl (P<0.01),A组1例患者需要输血治疗,B组无需输血病例。A组16例患者结石完全取净,B组2例残留结石直径分别为1.2cm和0.8cm,均行SWL治疗后结石排清。A组二期术后住院时间明显长于B组(5.8d：1.9d)。术后发热A组2例,B组1例,均经抗炎治疗后缓解。A组术后第1天平均血肌酐1.13±0.8mg/dL,高于术前0.92±0.21mg/dL(P<0.01),而B组手术前后的血肌酐分别为0.96±0.22mg/dL和0.95±0.13mg/dL,变化无统计学意义(P>0.05),术后随访1个月,A组和B组的平均血肌酐水平分别为0.93±0.18mg/dL和0.97±0.14mg/dL,与术前相比无统计学意义(P>0.05)。
结论：多通道微创经皮肾镜取石术与单通道微创经皮肾镜取石术联合输尿管软镜两种方法治疗复杂性肾结石均是安全、有效的,其手术治疗时间基本相同,多通道取石术组的结石清除率高于联合输尿管软镜组,但联合输尿管软镜组在减少手术出血量和住院时间方面具有一定的优势。
Chapter1:Single-tract minimally invasive percutaneous nephrolithotomy and staged flexible ureteroscopy in the treatment of complicacy kidney stone
Objective:To evaluate the efficacy and safety of staged single-tract minimally invasive percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopy in the treatment ofcomplicacy kidney stone.
Methods:From Jan2011ureteroscopy by a single surgeon. Twenty five patients were staghorn (31.6%), and the others were multiple kidney stone (68.4%). All patients underwent single-tract MPCNL througha20F tract and had most of the intrarenal calculi removed at the first stage. The second stage of retrograde flexible ureteroscopy was performed three to five days later after the drainage was cleared. The preoperative patient, characteristics, stone size, operative time and postoperative outcomes were then evaluated.
ResuIt:All operationwere successful and no major complications were noted in all patients. Theaverage operation time was(85±16) minutes at first stage and (46±21) minutes at second stage. The overall stone-free rate was92.4%after the second-stage procedures and only six patients had significant residue.
Conclusion:Staged single-tract MPCNL and flexible ureteroscopy are safe and effective for the management of complicacy kidney stone.
Chapter2:Combined minimally invasive percutaneous nephrolithotomy and retrograde flexible ureteroscopy in the treatment of complicacy kidney stone
Objective:To evaluate the efficacy and safety ofcombined minimally invasive percutaneous nephrolithotomy (MPCNL) andretrograde flexible ureteroscopy in the treatment of complicacy kidney stone.
Methods:From Jan2012to Nov2012, a total of62patients withcomplicacy kidney stone, including17complete staghorn calculi,31partial staghorn calculiand14multiple calculi, were treated with minimally invasive percutaneous nephrolithotomy and retrograde flexibleureteroscopy. All patients underwent MPCNL and removedmost of the intrarenal calculi. Mutip-MPCNL was performed when the the residual stones large than20mm in diameter. After the residual stones less than20mm in diameter, retrograde flexible ureteroscopy was performed. The preoperative patient, characteristics, stone size, operative time and postoperative outcomes were then evaluated.
Result:All operationwere successful and no major complications were noted in all patients. Only3patients can't search the residual stones, the other59patients can search the residual stonesand were performed retrograde flexible ureteroscopy in on session.Theaverage operation time was(125±18) minutes.Theoverall stone-free rate was72.6%after the operation and91.9%at1month later.
Conclusion:Combined minimally invasive percutaneous nephrolithotomy and retrograde flexible ureteroscopy are safe and effective for the management of staghorn calculi in one session.
Chapter3:Staged single-tract minimally invasive percutaneousnephrolithotomy and flexible ureteroscopy in the treatmentof staghorn stone in patients with solitary kidney
Objective:The aim of this study was to evaluate the outcome of staged single-tract minimally invasive percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopyas a minimally invasive option in the treatment of staghornstone in patients with a solitary kidney.
Methods:A total of24patients with staghorn stone in a solitary kidney weretreated with single-tract MPCNL and flexible ureteroscopyby a single surgeon. All the patients underwent single-tractMPCNL through a20F tract and had most of the intrarenalcalculi removed at the first stage. The second stage ofretrograde flexible ureteroscopy was performed3-5dayslater, after the drainage was cleared. The preoperativepatient, characteristics, stone size, operative time, renalfunctional status and postoperative outcomes were thenevaluated.
Result:Sixteen patients were partial staghorn (66.7%),and other eight were complete staghorn (33.3%). Theoverall stone-free rate was83.3%after the second-stageprocedures, and only four patients had significant residue.The hemoglobin drop ranged from1.1to3.7g/dl, and threepatients required blood transfusion. The mean serum creatinine value was1.7±0.8mg/dl before surgery and1.3±0.4mg/dl at the end of the follow-up period withstatistical significance (P<0.05). None of the patients hadincreased serum creatinine, and needed dialysis at the endof the follow-up period.
Conclusion:Staged single-tract MPCNL and flexible ureteroscopy are safe and effective for the management of staghorn stone in patients with a solitary kidneyand even in patients with impaired renal functions.
Chapter4:Clinical application of three-dimensional CT reconstruction for flexible ureteroscopy in the treatment of residual renal calculi after percutaneons nephrolithotomy
Objective:To evaluate the clinic effect of three-dimensional CT reconstruction for flexible ureteroscopy in the treatment of residual renal calculi after percutaneons nephrolithotomy.
Methods:From Jan2012to Aug2012, a total of42patients with renal calculi, including17single calculi and25mutiple calculi which residual after single tract minimally invasive percutaneous nephrolithotomy, were performed upper urinary tract non-enhanced CT scanning and three dimensional reconstruction. Flexible ureteroscopy was performed for the treatment of residual renal calculi by the directionof three-dimensional CT reconstruction. Stone size, operative time and postoperative outcomes were then evaluated.
Result:All operationwere successful and no major complications were noted in all patients. By the directionof three-dimensional CT reconstruction, flexible ureteroscopywas performed by retrograde in34cases and through the nephrostomy in14cases. Theaverage operation time was(52±11) minutes and the stone-free rate was95.2%.
Conclusion:Three-dimensional CT reconstruction provided a good map of the pelvicalyceal system and the accurately located of renal calculi, which was benefit for searching kidney calculi by flexible ureteroscopy, reducing operation time, improving stone-free rate and ensuring operation safety.
Chapter5:Comparative study on efficacy of multi-tract minimally invasive percutaneous nephrolithotomy and single-tract percutaneous nephrolithotomy with flexible ureteroscope in the treatment of complex renal calculi
Objective:To comparatively analyze the clinical efficacy of multi-tract percutaneous nephrolithotomy lithotomy (multi-tract MPCNL) and single-tract percutaneous nephrolithotomy lithotomy with flexible ureteroscope for the treatment of complex renal calculi.
Method:Select the patients which treated with single-tract MPCNLand residual multiple renal stones. Limited the diameter of single residual stones≤2cm. March2012to December2012,32patients were enrolled in this group, including19males and16females, mean age45.6±10.5years (range21-69years). According to the size of stones,32patients were divided into Group A and Group B. Group A was treated with multi-tractMPCNL. Group B was treated with single-tractMPCNLand flexible ureteroscope.After the first stage single-tractMPCNL, the second stage of operations were performed3-5dayslater when the drainage was cleared. Operative data, hospitalization periods, blood loss, serum creatinine changes and complications of the treated patients were recorded.
Results:All operations were successful and not serious complications occur. An average of1.4tract was created in group A. The average operative time was59.6±22.5min and63±24.8min in group A and group B (P>0.05). The average hemoglobin concentration decreased was0.83±0.76g/dl ingroup A and0.35±0.47g/dl in group B (P<0.01),1patients need blood transfusion therapy in Group A and none in Group B. Stone clear rate was100%in group A and87.5%in group B. The hospitalization periodswas longer in group A(5.8days:1.9days). In group A, the mean serum creatinine value was1.13±0.8mg/dL after the operation, which is higher than the preoperative,0.92±0.21mg/dL (P<0.01). In group B, the mean serum creatinine value were0.96±0.22mg/dL and0.95±0.13mg/dLbefore and after surgery (P>0.05). However, both group A and group B, compared with preoperative, the mean serum creatinine value were on significantly1month later.
Conclusion:Both multi-tractMPCNLand single-tractMPCNLwith flexible ureteroscope are safe and effective for treatment of complex renal calculi. Compare to single-tractMPCNLwith flexible ureteroscope, the single-tractMPCNLwith flexible ureteroscope has certain advantages in reducing operative bleeding and hospitalization time.
目的：探讨单通道微创经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石的有效性及安全性。
方法：自2011年1月至2012年2月采用“一期单通道微创经皮肾镜取石术、二期截石斜仰卧位下联合逆行输尿管软镜碎石取石术”治疗方法79例复杂性肾结石患者,其中左侧肾结石40例,右侧肾结石32例,双侧肾结石7例；铸型肾结石25例,肾多发结石54例,结石直径1.2-4.8cm,功能性孤立肾24例,血肌酐及尿素氮有不同程度升高的31例。16例有开放取石病史,合并高血压病21例,糖尿病12例,泌尿系感染33例。
结果：所有手术均成功建立20F工作通道并行一期经皮肾镜碎石取石,一期手术时间32-176min,平均(85+16)min。术后第2天复查KUB,中盏结石残留21例,上盏结石残留13例,下盏结石残留12例,多发结石残留33例。术后第3-5天行二期逆行输尿管软镜取石术,术中均可探及结石,采用钬激光碎石治疗,其中68例联合应用套石蓝套取结石至肾盂内,经原经皮肾工作通道进行碎石取石,二期手术时间18-134min,平均(46±21)min,二期结石清除率为92.4%(73/79)。6例结石残留患者行术后1月行体外冲击波碎石治疗,4例碎石后结石完全排出,2例残留结石直径均小于1.Ocm。未出现气胸、肠道损伤及大出血等严重并发症。随访时间1～13月,残留结石未见移位,未引起梗阻。
结论：单通道经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石有利于减少手术并发症并提高结石清除率,方法安全、有效,值得临床推广。
第二章微创经皮肾镜取石术一期联合输尿管软镜治疗复杂性肾结石
目的：探讨微创经皮肾镜取石术一期联合逆行输尿管软镜治疗复杂性肾结石的有效性及安全性。
方法：自2012年1月至2012年12月,采用微创经皮肾镜取石术一期联合逆行输尿管软镜治疗复杂性肾结石62例。其中左侧肾结石29例,右侧肾结石33例,完全性铸型结石17例,不完全性铸型结石31例,多发性结石14例,直径2.1-4.9cm。13例患侧肾脏有开放取石病史,合并高血压病8例,糖尿病7例,泌尿系感染16例。首先建立经皮肾镜工作通道并一期碎石取石,应用微创肾镜取出所能探及的所有结石后,C臂X线机透视检查残留结石,若残留结石直径大于20mm,采用多通道取石,穿刺结石所在肾盏并建立经皮肾镜通道,取出结石；对于残留结石直径小于20mm的,采用逆行输尿管软镜取石。
结果：所有手术均成功建立经皮肾镜工作通道并一期碎石取石,其中单通道取石46例,双通道取石16例。经皮肾镜取石术后残留上盏结石残留14例,中盏结石残留21例,下盏结石残留12例,多发结石残留15例。62例患者中,3例应用输尿管软镜无法探及结石,余59例逆行输尿管软镜均探及残留结石并采用钬激光碎石治疗。47例联合应用套石蓝套取结石至肾盂内,经原经皮肾工作通道进行碎石取石。平均手术时间(125±18)min,术后第2天结石清除为72.6%(45/62),术后1月结石清除率为91.9%(57/62)。未出现气胸、肠道损伤、大出血或尿源性脓毒血症等严重并发症。
结论：微创经皮肾镜取石术一期联合逆行输尿管软镜治疗铸型肾结石安全、有效,值得临床推广。
第三章单通道微创经皮肾镜取石术联合二期逆行输尿管软镜治疗孤立肾铸型结石
目的：探讨分期单通道微创经皮肾镜取石术联合逆行输尿管软镜治疗孤立肾铸型结石的有效性及安全性。
方法：回顾性分析2007年4月份至2010年3月份应用微创经皮肾镜取石术及输尿管软镜钬激光碎石手术治疗孤立肾合并铸型结石患者24例。24例孤立肾患者中,先天性孤立肾2例,对侧肾切除5例,对侧肾脏无功能17例。完全性铸型结石16例(66.7%),不完全性铸型结石8例(33.3%),结石平均表面积1501.8±899.7mm2(512-5630mm2)。术前平均血肌酐1.7±0.8mg/dl(0.5-4.9mg/d1),11例患者术前血肌酐大于1.4mg/dl。合并高血压病4例,糖尿病3例,泌尿系感染11例。
手术均由同一泌尿外科医师进行操作,微创经皮肾镜取石通道限制为单通道。建立20F微创经皮肾取石通道,F12李逊微创肾镜经工作通道进入肾集合系统,应用气压弹道碎石器或钬激光击碎结石,利用鳄鱼嘴钳取出较大结石,小结石可通过微创肾镜连接负压吸引器吸出。术毕保留输尿管外支架管及肾造瘘管,一期术后3-5天,肾造瘘管引流液转清后行二期手术治疗。二期手术操作中,患者取截石斜仰卧位,输尿管置入12F输尿管软镜工作鞘,7.2F的输尿管软镜经工作鞘进入肾集合系统内寻找结石后并应用200um钬激光碎石,较大结石应用套石篮套取结石至肾盂内,经原经皮肾取石通道碎石并取出。
结果：本组病例中,2例患者一期单通道微创经皮肾取石术取净结石,余22例患者均行二联合输尿管软镜取石。22例结石残留患者,一期微创经皮肾镜取石术后平均结石表面积降至235.8±353.3mm2。微创经皮肾镜取石平均手术时间64.2±25.5min(32-180min),二期联合逆行输尿管软镜手术时间116.2±33min (24-173min)。二期术后总结石清除率83.3%,仅4例术后结石残留。术中及术后无明显的手术并发症发生,平均血红蛋白浓度下降1.1-3.7g/dl。3例患者需要输血治疗,其中有2例合并术前贫血。一期术后发热患者4例,均经抗炎治疗后缓解。本组平均随访时间21.3±3.2月(9-38月),平均血肌酐水平从术前1.7±0.8mg/dl下降至术后1.3±0.4mg/dl(P<0.05)。术前11例肾功能不全患者中,4例术后肌酐降至正常水平,7例患者肌酐水平稳定在1.4-2.7mg/dl之间,没在患者肾功能明显恶化或需要血透治疗。
结论：单通道经皮肾镜取石术联合逆行输尿管软镜治疗孤立肾铸型结石安全、有效,值得临床推广。
第四章CT三维重建在微创经皮肾镜取石联合输尿管软镜处理肾结石中的应用
目的：探讨CT三维重建在微创经皮肾镜取石术联合输尿管软镜处理肾结石中的应用价值。
方法：自2012年1月至2012年8月,对微创单通道经皮肾镜取石术后残留结石42例患者行上尿路CT三维重建,充分了解肾脏集合系统结构、结石分布及结石与肾盂肾盏间的关系,测量结石所在肾盏长轴与经皮肾造瘘通道及肾盂间的夹角,指导二期输尿管软镜处理结石。
结果：CT发现单发肾结石17例,多发肾结石25例,结石直径0.4-2.1cm。测得结石所在肾盏长轴与肾盂长轴间的夹角为8-207°,平均夹角870；结石所在肾盏长轴与经皮肾造瘘通道的夹角为0-1350,平均夹角43°。选取夹角较大的通道作为输尿管软镜入镜路径。所有患者术中均可探及结石,采用钬激光碎石治疗,经输尿管工作鞘软镜取石34例次,经皮肾造瘘通道输尿管软镜取石14例次。手术时间16-112min,平均(52+11)min,结石清除率为95.2%(40/42),2例结石残留直径均小于1cm。本组无改开放手术病例,未出现感染性休克、气胸及大出血等严重并发症。
结论：上尿路CT三维重建可形象直观地显示肾脏的解剖结构及与结石间的关系,有助于指导输尿管软镜寻找结石、减少手术时间并提高结石清除率和手术安全性。
第五章多通道微创经皮肾镜取石术与单通道微创经皮肾镜取石术联合输尿管软镜治疗复杂性肾结石的对比研究
目的：比较多通道微创经皮肾镜取石术与单通道微创经皮肾镜取石术联合输尿管软镜治疗复杂性肾结石的临床疗效。
方法：选取本单位应用单通道微创经皮肾镜取石术后肾结石残留患者进行手术治疗,要求残留结石为多发,且单个结石直径≤2cm。2012年3月至2012年12月32例患者入选本组资料,其中男19例,女13例,平均年龄45.6±10.5岁(21-69岁)。32例患者随机分为A组和B组,每组各16例,A组采用多通道微创经皮肾取石,B组在原微创经皮肾镜取石通道的基础上联合逆行输尿管软镜进行取石。两组二期手术操作均在一期术后第3-5天肾造瘘管引流液变清后进行。分析对比两组资料的手术时间、血红蛋白浓度下降值、结石清除率、住院时间及术前后的血肌酐变化。
结果：所有手术均成功探及结石并进行碎石取石,无大出血、败血症、邻近脏器损伤等严重并发症发生。A组二期新建立通道1-3个,平均1.4个。A组和B组的平均手术时间分别为59.6+22.5min和63±24.8min,差异无统计学意义(P>0.05)。A平均血红蛋白浓度下降0.83±0.76g/dl,血红蛋白浓度下降高于B组0.35±0.47g/dl (P<0.01),A组1例患者需要输血治疗,B组无需输血病例。A组16例患者结石完全取净,B组2例残留结石直径分别为1.2cm和0.8cm,均行SWL治疗后结石排清。A组二期术后住院时间明显长于B组(5.8d：1.9d)。术后发热A组2例,B组1例,均经抗炎治疗后缓解。A组术后第1天平均血肌酐1.13±0.8mg/dL,高于术前0.92±0.21mg/dL(P<0.01),而B组手术前后的血肌酐分别为0.96±0.22mg/dL和0.95±0.13mg/dL,变化无统计学意义(P>0.05),术后随访1个月,A组和B组的平均血肌酐水平分别为0.93±0.18mg/dL和0.97±0.14mg/dL,与术前相比无统计学意义(P>0.05)。
结论：多通道微创经皮肾镜取石术与单通道微创经皮肾镜取石术联合输尿管软镜两种方法治疗复杂性肾结石均是安全、有效的,其手术治疗时间基本相同,多通道取石术组的结石清除率高于联合输尿管软镜组,但联合输尿管软镜组在减少手术出血量和住院时间方面具有一定的优势。
Chapter1:Single-tract minimally invasive percutaneous nephrolithotomy and staged flexible ureteroscopy in the treatment of complicacy kidney stone
Objective:To evaluate the efficacy and safety of staged single-tract minimally invasive percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopy in the treatment ofcomplicacy kidney stone.
Methods:From Jan2011ureteroscopy by a single surgeon. Twenty five patients were staghorn (31.6%), and the others were multiple kidney stone (68.4%). All patients underwent single-tract MPCNL througha20F tract and had most of the intrarenal calculi removed at the first stage. The second stage of retrograde flexible ureteroscopy was performed three to five days later after the drainage was cleared. The preoperative patient, characteristics, stone size, operative time and postoperative outcomes were then evaluated.
ResuIt:All operationwere successful and no major complications were noted in all patients. Theaverage operation time was(85±16) minutes at first stage and (46±21) minutes at second stage. The overall stone-free rate was92.4%after the second-stage procedures and only six patients had significant residue.
Conclusion:Staged single-tract MPCNL and flexible ureteroscopy are safe and effective for the management of complicacy kidney stone.
Chapter2:Combined minimally invasive percutaneous nephrolithotomy and retrograde flexible ureteroscopy in the treatment of complicacy kidney stone
Objective:To evaluate the efficacy and safety ofcombined minimally invasive percutaneous nephrolithotomy (MPCNL) andretrograde flexible ureteroscopy in the treatment of complicacy kidney stone.
Methods:From Jan2012to Nov2012, a total of62patients withcomplicacy kidney stone, including17complete staghorn calculi,31partial staghorn calculiand14multiple calculi, were treated with minimally invasive percutaneous nephrolithotomy and retrograde flexibleureteroscopy. All patients underwent MPCNL and removedmost of the intrarenal calculi. Mutip-MPCNL was performed when the the residual stones large than20mm in diameter. After the residual stones less than20mm in diameter, retrograde flexible ureteroscopy was performed. The preoperative patient, characteristics, stone size, operative time and postoperative outcomes were then evaluated.
Result:All operationwere successful and no major complications were noted in all patients. Only3patients can't search the residual stones, the other59patients can search the residual stonesand were performed retrograde flexible ureteroscopy in on session.Theaverage operation time was(125±18) minutes.Theoverall stone-free rate was72.6%after the operation and91.9%at1month later.
Conclusion:Combined minimally invasive percutaneous nephrolithotomy and retrograde flexible ureteroscopy are safe and effective for the management of staghorn calculi in one session.
Chapter3:Staged single-tract minimally invasive percutaneousnephrolithotomy and flexible ureteroscopy in the treatmentof staghorn stone in patients with solitary kidney
Objective:The aim of this study was to evaluate the outcome of staged single-tract minimally invasive percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopyas a minimally invasive option in the treatment of staghornstone in patients with a solitary kidney.
Methods:A total of24patients with staghorn stone in a solitary kidney weretreated with single-tract MPCNL and flexible ureteroscopyby a single surgeon. All the patients underwent single-tractMPCNL through a20F tract and had most of the intrarenalcalculi removed at the first stage. The second stage ofretrograde flexible ureteroscopy was performed3-5dayslater, after the drainage was cleared. The preoperativepatient, characteristics, stone size, operative time, renalfunctional status and postoperative outcomes were thenevaluated.
Result:Sixteen patients were partial staghorn (66.7%),and other eight were complete staghorn (33.3%). Theoverall stone-free rate was83.3%after the second-stageprocedures, and only four patients had significant residue.The hemoglobin drop ranged from1.1to3.7g/dl, and threepatients required blood transfusion. The mean serum creatinine value was1.7±0.8mg/dl before surgery and1.3±0.4mg/dl at the end of the follow-up period withstatistical significance (P<0.05). None of the patients hadincreased serum creatinine, and needed dialysis at the endof the follow-up period.
Conclusion:Staged single-tract MPCNL and flexible ureteroscopy are safe and effective for the management of staghorn stone in patients with a solitary kidneyand even in patients with impaired renal functions.
Chapter4:Clinical application of three-dimensional CT reconstruction for flexible ureteroscopy in the treatment of residual renal calculi after percutaneons nephrolithotomy
Objective:To evaluate the clinic effect of three-dimensional CT reconstruction for flexible ureteroscopy in the treatment of residual renal calculi after percutaneons nephrolithotomy.
Methods:From Jan2012to Aug2012, a total of42patients with renal calculi, including17single calculi and25mutiple calculi which residual after single tract minimally invasive percutaneous nephrolithotomy, were performed upper urinary tract non-enhanced CT scanning and three dimensional reconstruction. Flexible ureteroscopy was performed for the treatment of residual renal calculi by the directionof three-dimensional CT reconstruction. Stone size, operative time and postoperative outcomes were then evaluated.
Result:All operationwere successful and no major complications were noted in all patients. By the directionof three-dimensional CT reconstruction, flexible ureteroscopywas performed by retrograde in34cases and through the nephrostomy in14cases. Theaverage operation time was(52±11) minutes and the stone-free rate was95.2%.
Conclusion:Three-dimensional CT reconstruction provided a good map of the pelvicalyceal system and the accurately located of renal calculi, which was benefit for searching kidney calculi by flexible ureteroscopy, reducing operation time, improving stone-free rate and ensuring operation safety.
Chapter5:Comparative study on efficacy of multi-tract minimally invasive percutaneous nephrolithotomy and single-tract percutaneous nephrolithotomy with flexible ureteroscope in the treatment of complex renal calculi
Objective:To comparatively analyze the clinical efficacy of multi-tract percutaneous nephrolithotomy lithotomy (multi-tract MPCNL) and single-tract percutaneous nephrolithotomy lithotomy with flexible ureteroscope for the treatment of complex renal calculi.
Method:Select the patients which treated with single-tract MPCNLand residual multiple renal stones. Limited the diameter of single residual stones≤2cm. March2012to December2012,32patients were enrolled in this group, including19males and16females, mean age45.6±10.5years (range21-69years). According to the size of stones,32patients were divided into Group A and Group B. Group A was treated with multi-tractMPCNL. Group B was treated with single-tractMPCNLand flexible ureteroscope.After the first stage single-tractMPCNL, the second stage of operations were performed3-5dayslater when the drainage was cleared. Operative data, hospitalization periods, blood loss, serum creatinine changes and complications of the treated patients were recorded.
Results:All operations were successful and not serious complications occur. An average of1.4tract was created in group A. The average operative time was59.6±22.5min and63±24.8min in group A and group B (P>0.05). The average hemoglobin concentration decreased was0.83±0.76g/dl ingroup A and0.35±0.47g/dl in group B (P<0.01),1patients need blood transfusion therapy in Group A and none in Group B. Stone clear rate was100%in group A and87.5%in group B. The hospitalization periodswas longer in group A(5.8days:1.9days). In group A, the mean serum creatinine value was1.13±0.8mg/dL after the operation, which is higher than the preoperative,0.92±0.21mg/dL (P<0.01). In group B, the mean serum creatinine value were0.96±0.22mg/dL and0.95±0.13mg/dLbefore and after surgery (P>0.05). However, both group A and group B, compared with preoperative, the mean serum creatinine value were on significantly1month later.
Conclusion:Both multi-tractMPCNLand single-tractMPCNLwith flexible ureteroscope are safe and effective for treatment of complex renal calculi. Compare to single-tractMPCNLwith flexible ureteroscope, the single-tractMPCNLwith flexible ureteroscope has certain advantages in reducing operative bleeding and hospitalization time.
引文
1. Tiselius HG. Stone incidence and prevention. Braz J Urol,2000,26(5):452-462.
2. Litwin MS, Saigal CS, Yano EM, et al. Urologic diseases in America Project: analytical methods and principal findings. J Urol,2005,173(3):933-937.
3.孙伟桂,丁智仁,张峻,等.广西地区尿石症患者年龄分布曲线特征及临床意义.中华泌尿外科杂志,2001,22(2)：100-102.
4.叶章群,邓耀良,董诚主编.泌尿系结石[M].北京：人民卫生出版社,2003.
5.邓耀良,复杂性肾结石的外科治疗.临床泌尿外科学杂志,2006,21(2)：81-84.
6.那彦群.中国泌尿外科疾病诊断治疗指南.北京：人民卫生出版社,2007：175-8.
7. Preminger GM, Assimos DG, Lingeman JE, el al. Chapterl:AUA guideline on m anagem ent of staghorn calculi:diagnosis and treatment recommendations. J Urol, 2005,173:1991-2000.
8. Tiselius HG, Ackermann D, Alken P, et al. Guidelines on Urolithiasis[J]. In:EAU guidelines. EAU,2006,5-6.
9. Rupel E, Brown R. Nephroscopy with removal of stone following nephrostomy for obstructive calculous anuria. J Urol,1941,46:177-9.
10. Goodwin WE, Casey WC, Woolf W. Percutaneous trocar (needle) nephrostomy in hydronephrosis. JAMA,1955,157:891-4.
11. Fernstrom I, Johansson B. Percutaneous pyelolithotomy. A new extractiontechnique. Scand J Urol Nephrol,1976,10:257-9.
12. Wickham JE, Kellett MJ. Percutaneous nephrolithotomy. Br J Urol,1981, 53:297-9.
13. Smith AD, Reinke DB, Miller RP, et al. Percutaneous nephrostomy in the management of ureteral and renal calculi. Radiology,1979,133:49-54.
14. Gunther R, AlkenP.Percutaneous Nephrostomy in Obstructive Uropathy. Radiology Today,1983,2:94-100.
15. Alken P, Hutschenreiter G, Gunther R, et al. Percutaneous stone manipulation. J Urol.1981,125:463-6.
16. Segura JW, Patterson DE, LeRoy AJ, et al. Percutaneous removal of kidney stones:preliminary report. Mayo Clin Proc.1987,57:615-9.
17. Marberger M, Steckl W, Hruby W. Percutaneous litho-lapaxy of renal calculi with ultrasound. Eur Urol.1982,8:236-42.
18.叶章群.中国泌尿外科疾病诊断治疗指南/尿石症诊治指南.北京：人民卫生出版社,2010.
19. Helal M, Black T, Lockhart J, et al. The Hickman peel-away sheath:alternative for pediatric percutaneous nephrolithotomy. J Endourol.1997,11:171-2.
20. Jackman SV, Docimo SG, Cadeddu JA, et al. The'mini-perc'technique:a less invasive alternative to percutaneous nephrolithotomy. World J Urol. 1998,16:371-4.
21. Monga M, Oglevie S. Minipercutaneous nephrolithotomy. J Endourol.2000, 14:419-21.
22. Lahme S, Bichler KH, Strohmaier WL, et al. Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol.2001,40:619-24.
23.郭应禄,潘柏年,薛兆英,等.经皮肾镜穿刺取石术.中华外科杂志,1986,24：34-5.
24.余安迪,王邦宏,吴腾斐,等.经皮穿刺肾石取出术42例初步报告.中华泌尿外科杂志,1986,7：67-9.
25.杨运彰,吴开俊,袁坚,等.经皮穿刺肾造痰取石术.中华医学杂志,1986, 66：279-81.
26.吴开俊,李逊,袁坚,等.经皮肾微造瘘术后二期经皮输尿管镜取石术治疗鹿角形结石.广州医学院学报,1993,21：13-5.
27.李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36：124-6.
28. Li SK, Tai D, Chau L, Fung B. Minimally invasive percutaneous nephrolithotomy (MPCNL) according to the Chinese method. In:Baba S, Ono Y, eds. Recent Advances in Endourology. New York:Springer,2006,8, pp.41-63.
29. Fanardzhian SV. Complications of percutaneous nephrolithotripsy in staghorn nephrolithiasis. Georgian Med News.2010, (187):7-12.
30. Rudnick DM, Stoller ML. Complications of percutaneousnephrostolithotomy. Can J Urol 1999;6:872-5.20
31. Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy.Eur Urol,2007,51 (4):899-906.
32. Pardalidis NP, Smith AD. Complications of percutaneous renal procedures.In: Controversies in Endourology. Philadelphia:WB Saunders,1995, p 179.
33. Kessaris DN, Bellman GC, Pardalidis NP, Smith AD. Managementof hemorrhage after percutaneous renal surgery. J Urol 1995; 153:604.
34. Stoller ML, Wolf JS, St Lezin MA. Estimated blood loss and transfusionrates associated with percutaneous nephrolithotomy. J Urol 1994; 152:1977.
35. Netto R, Lemos GC, Palma PC, Fiuza JL. Staghorn calculi:Percutaneousversus anatrophic nephrolithotomy. Eur Urol 1988; 15:9.
36. Kahnoski RJ, Lingeman JE, Coury TA, Steele RE, Mosbaugh PGCombined percutaneous and extracorporeal shock wave lithotripsyfor staghorn calculi:An alternative to anatrophic nephrolithotomyJ Urol 1986; 135:679.
37. Snyder JA, Smith AD. Staghorn calculi:Percutaneous extractionversus anatrophic nephrolithotomy. J Urol 1986; 131:351.
38. Schulze H, Hertle L, Kumpf HP, et al. Critical evaluation of treatmentof staghorn calculi by percutaneous nephrolithotomy and extracorporealshock wave lithotripsy. J Urol 1989; 141:822.
39. Assimos DG, Wrenn JJ, Harrison LH, et al. A comparison of anatrophicnephrolithotomy and percutaneous nephrolithotomy withand without extracorporeal shock wave lithotripsy for managementof patients with staghorn calculi. J Urol 1991; 145:710.
40. Lam HS, Lingeman JE, Baccon, M, et al. Staghorn calculi:Analysisof treatment results between initial percutaneous ephrostolithotomyand extracorporeal shock wave lithotripsy monotherapywith reference to surface area. J Urol 1992;147:1219.
41. Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study. J Endourol,2004,18: 715-722.
42.徐桂彬,李逊,何朝辉,等.微创经皮肾镜取石术出血量影响因素的分析.中华泌尿外科杂志,2007,7：456-459.
43.李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36(02)：124-126.
44.曾国华,钟文,李逊,等.一期多通道微创经皮肾穿刺取石术治疗鹿角状结石.中华泌尿外科杂志,2007,4：250-252.
45. Marshall VF. Fiber optics in urology. Urology,1964,91:110-111.
46. Takagi T, Go T, Takayasu H, Aso Y. Fiberoptic pyeloureteroscope. Surgery, 1971,70(5):661-663.
47. Bagley Dh, Huffman Jl, Lyon Es. Combined rigid and flexible ureteropyeloscopy. J Urol,1983,130:243-244.
48. Razvan M, Bogdan G, Dragos G, et al. Conventional Fiberoptic Flexible Ureterscope Versus Fourth Generation Distal Flexible Ureteroseope:A Critical Comparison.2010,21(1):17-21.
49. Watson Gm, Wickham Jea. Initial experience with a pulsed dye laser for ureteric calculi. Lancet 1986; i:1357-1358.
50. Sofer M, Watterson JD, Wollin TA, ea al. Holmium:YAG lithotripsy for upper urinary tract calculi in 598 patients. J Urol,2002,167:31-34.
51.孙颖浩,戚晓升,王林辉,等.输尿管软镜下钬激光碎石术治疗肾盏结石.临床泌尿外科杂志,2004,19(3)：139-141.
52. Defidio L, Dominicis M. Flexible ureteroscopy for kidney stones in children. Arch Ital Urol Androl.2010,82(1):53-55.
53. Abdel-Razzak OM, Bagley DH.Clinical experience with flexible ureteropyeloscopy. J Urol.1992,148(6):1788-1792.
54. Auge BK, Dahm P, Wu NZ, Preminger GM. Ureteroscopicmanagement of lower-pole renal calculi:Technique of calculus displacement. J Endourol, 2001,15:835-838.
55. Breda A, Ogunyemi O, Leppert JT, et al. Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater--is this the new frontier? J Urol,2008,179(3):981-984.
56. Hyams ES, Munver R, Bird VQ et al. Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm:a multi-institutional experience. J Endourol,2010,24(10):1583-1588.
57. Knudsen B, Miyaoka R, Shah K, et al. Durability of the next generation flexible flberoptic ureteroscopes:a randomized prospectire multi-institutional clinical trial. Urology,2010,75:534-538.
58. Landman J, Venkatesh R, Lee DI, Rehman J, et al. Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy. J Urol,2003,169(1):64-67.
59. Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 96(7):1097-1100.
[1]Fernstrom I, Johansson B. Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol,1976,10:257-9.
[2]Matlaga BR, Kim SC, Lingeman JE. Improving outcomes of percutaneous nephrolithotomy:Access. EAU Update Series,2005,3:37-43.
[3]Raj GV, Auge BK, Weizer AZ, et al. Percutaneous management of calculi within horseshoe kidneys. J Urol,2003,170:48-51.
[4]Jackman SV, Docimo SG, Cadeddu JA, et al. The'mini-perc'technique:a less invasive alternative to percutaneous nephrolithotomy. World J Urol,1998,16:371-4.
[5]李逊,曾国华,吴开俊.微创经皮肾穿刺取石术治疗上尿路结石.临床泌尿外科杂志,2003,18(9)：516-518.
[6]李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36(2)：124-126.
[7]叶章群.中国泌尿外科疾病诊断治疗指南/尿石症诊治指南.北京：人民卫生出版社,2010.
[8]Preminger GM, Assimos DG, Lingeman JE, et al. Chaptel 1:AUA guideline om management of staghorn calculi:diagnosis and treatment recommendations. J Urol,2005,173:1991-2000.
[9]李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36(2)：124-126.
[10]曾国华,钟文,李逊,等.一期多通道微创经皮肾穿刺取石术治疗鹿角状结石.中华泌尿外科杂志,2007,4：250-252).
[11]徐桂彬,李逊,何朝辉,等.微创经皮取石术出血量影响因素的分析.中华 泌尿外科杂志,2007,28(07)：456-459.
[12]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study. J Endourol,2004, 18(8):715-722.
[13]Hussain M, Archer P, Penev B, et al. Redefining the limits of flexible ureterorenoscopy. J Endourol,2010,25(1):45.
[14]Prabhakar M. Retrograde ureteroscopic intrarenal surgery for large (1.6-3.5 cm) upper ureteric/renal calculus. Indian J Urol,2010,26(1):46-49.
[15]Xun Li, Zhaohui He, Kaijun Wu, et al. Chinese Minimally Invasive Percutaneous Nephrolithotomy:The Guangzhou Experience. J Endourol,2010, 25(9):1421-5.
[16]Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 96(7):1097-1100.
[1]Preminger GM, Assimos DG, Lingeman JE, et al. Chaptel 1:AUA guideline om management of staghorn calculi:diagnosis and treatment recommendations. J Urol,2005,173:1991-2000.
[2]Abdel-Razzak OM, Bagley DH. Clinical experience with flexible ureteropyeloscopy. J Urol,1992,148(6):1788-1792.
[3]Landman J, Venkatesh R, Lee Dl, et al. Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy. J Urol,2003,169:64-7.
[4]李逊,徐桂彬,何永忠,等.单通道经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石疗效观察(附79例报告).临床泌尿外科杂志,2012,27(6)：452-454.
[5]Desai M, Ganpule A, Monahar T. "Multiperc" for complete staghorn calculus[J]. J Endourol 2008,22:1831-1841.
[6]徐桂彬,李逊,何朝辉,等.微创经皮取石术出血量影响因素的分析.中华泌尿外科杂志,2007,28(07)：456-459.
[7]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study. J Endourol,2004,18(8): 715-722.
[8]Breda A, Ogunyemi O, Leppert J, et al. Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater-is this the new frontier?. J Urol,2008,179(3):981-984.
[9]Hussain M, Archer P, Penev B, et al. Redefining the limits of flexible ureterorenoscopy. J Endourol,2010,25(1):45.
[10]Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 96(7):1097-1100.
[11]Guibin Xu, Xun Li, Yongzhong He, et al. Staged single-tract minimally invasive percutaneous nephrolithotomy and flexible ureteroscopy in the treatment of staghorn stone in patients with solitary kidney. Urological Research,2012,40(6):745-749.
[1]叶章群.尿石症诊断治疗指南.见：那彦群,主编.中国泌尿外科疾病诊断治疗指南.北京：人民生出版社,2007,267.
[2]叶向东,梁志雄.多通道微创经皮肾取石术治疗孤立肾肾结石.中国医师杂志.2006,2：205-206.
[3]朱建国,王元林,杨秀书,等.微创经皮肾镜取石术治疗孤立肾合并肾结石.中国内镜杂志,2006,11：2010-2012.
[4]颜冰,付杰新,谢光宇,等.微创经皮肾镜取石术治疗孤立肾肾结石.基层医学论坛.2008,12：484-486.
[5]刘星明,任胜强,邬旭明,等.微创经皮肾镜取石术治疗孤立肾肾结石(26例报告).临床泌尿外科杂志,2007,3：177-178.
[6]李逊,徐桂彬,何永忠,等.微创经皮肾取石术治疗孤立肾铸型结石的疗效观察.临床泌尿外科杂志,2009,24：653-5.
[7]Fernstrom I, Johansson B. Percutaneous pyelolithotomy:a new extraction technique. Scand J Urol Nephrol,1976,10(3):257-259.
[8]Fanardzhian SV. Complications of percutaneous nephrolithotripsy in staghorn nephrolithiasis. Georgian Med News,2010,187:7-12.
[9]Rudnick DM, Stoller ML. Complications of percutaneous nephrostolithotomy. Can J Urol,1999,6:872-520
[10]Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. Eur Urol,2007,51(4):899-906.
[11]Li X, He Z, Wu K, Li SK, et al. Chinese minimally invasive percutaneous nephrolithotomy:the Guangzhou experience. J Endourol,2009, 23(10):1693-1697.
[12]Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 96(7):1097-1100.
[13]Zhong W, Zeng G, Wu W, et al. Minimally invasive percutaneous nephrolithotomy with multiple mini tracts in a single session in treating staghorn calculi. Urol Res,2011,39(2):117-122.
[14]Hyams ES, Munver R, Bird VG, et al. Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm:a multi-institutional experience. J Endourol,2010,24(10):1583-1588.
[15]Preminger GM, Assimos DG, Lingeman JE, el al. Chapterl:AUA guideline on management of staghorn calculi:diagnosis and treatment recommendations. J Urol,2005,173:1991-2000.
[16]Liatsikos EN, Kallidonis P, Stolzenburg JU, et al. Percutaneous management of staghorn calculi in horseshoe kidneys:a multi-institutional experience. J Endourol,2010,24(4):531-536.
[17]Resorlu B, Kara C, Oguz U, et al. Percutaneous nephrolithotomy for complex caliceal and staghorn stones in patients with solitary kidney. Urol Res,2011, 39(3):171-176.
[18]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study. J Endourol,2004,18(8): 715-722.
[19]El-Nahas AR, Shokeir AA, El-Assmy AM, et al. Post-percutaneous nephrolithotomy extensive hemorrhage:a study of risk factors. J Urol,2007, 177(2):576-579.
[20]Lam HS, Lingeman JE, Mosbaugh PG, et al. Evolution of the technique of combination therapy for staghorn calculi:a decreasing role for extracorporeal shock wave lithotripsy. J Urol,1992,148(3 Pt 2):1058-1062.
[21]Chibber PJ. Percutaneous nephrolithotomy for large and staghorn calculi. J Endourol,1993,7(4):293-295.
[22]Koga S, Arakaki Y, Matsuoka M, et al. Staghorn calculi--long-term results of management. Br J Urol,1991,68(2):122-124.
[23]Breda A, Ogunyemi O, Leppert JT, et al. Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater--is this the new frontier? J Urol,2008,179(3):981-984.
[24]Landman J, Venkatesh R, Lee DI, Rehman J, et al. Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy. J Urol,2003,169(1):64-67.
[1]Hubert J, Blum A, Cormier L, et al. Three-dimensional CT-scan reconstruction of renal calculi:A new tool for mapping-out staghorn calculi and follow-up of radiolucent stones. Eur Urol,1997,31:297-301.
[2]孟祥军,米其武,等.CT三维重建辅助经皮肾镜术穿刺定位.临床和实验医学杂志,2007,6(6)：55-57.
[3]李逊,孟祥军,曾国华,等.C T三维重建在经皮肾镜取石术中的应用价值.中华泌尿外科杂志,2007,28(6)：379-381.
[4]孙颖浩,高旭,高小峰,等.输尿管软镜下钬激光碎石术治疗肾盏结石.临床泌尿外科杂志,2004,19(3)：139-141.
[5]Geavlete P, Multescu R, Geavelete B, et al. Influence of pyelocaliceal anatomy on the success of flexible ureteroscopi approach. J Endourdl,2008,22(10):22.
[6]Preminger GM, Assimos DG, Lingeman JE, et al. Chaptel 1:AUA guideline om management of staghorn calculi:diagnosis and treatment recommendations. J Urol,2005(173):1991-2000.
[7]Desai M, Ganpule A, Monahar T. "Multiperc" for complete staghorn calculus. J Endourol 2008,22:1831-1841.
[8]徐桂彬,李逊,何朝辉,等.微创经皮取石术出血量影响因素的分析.中华泌尿外科杂志,2007,28(07)：456-459.
[9]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study. J Endourol,2004, 18(8):715-722.
[10]Hussain M, Archer P, Penev B, et al. Redefining the limits of flexible ureterorenoscopy. J Endourol,2010,1:45.
[11]Geavlete P, Aghamiri SA, Multescu R. Retrograde flexible ureteroscopic approach for pyelocaliceal calculi. Urol J,2006,3(1):15-9;
[12]Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 7:1097-1100.
[13]李逊,徐桂彬,何永忠,等.单通道经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石疗效观察(附79例报告).临床泌尿外科杂志,2012,27：452-454.
[14]Geavlete P, Multescu R, Geavelete B, et al. Influence of pyelocaliceal anatomy on the success of flexible ureteroscopy approach. J Endourdl,2008,22(10):22.
[15]Petrisor G, Razvall M, Bogdan G. Influence of pyelocaliceal anatomy on the success of flexible ureteroscopic approach. Journal of endourology.2008, 22(10):2235-2239.
[16]Kumar P, Keeley FX, Timoney AG Retrograde ureteropyeloscopy caliceal calculi. J Urol,2000,164(4):1318.
[17]孙颖浩,戚晓升,王林辉,等.输尿管软镜下钬激光碎石术治疗肾结石(附51例报告).中华泌尿外科杂志,2002,23：681-682.
[18]Grasso M, Bagley D. Small diameter, actively deflectable, flexible ureteropyeloscopy. J Urol,1998,160(5):1648-1653.
[19]Shvarts O,Perry KT, Goff B, et al. Improved functiona 1 deflection with a dual-deflection flexible ureteroscope. J Endourol,2004,18(2):141-144.
[20]Pasqui F, Dubosq F, Tchala K, et al. Impact on active scope deflection and irrigation flow of all endoscopic working tools during flexible ureteroscopy. Eur Urol,2004,45 (1):58-64.
[1]Preminger GM, Assimos DQ Lingeman JE, el al. Chapter1:AUA guideline on m anagem ent of staghorn calculi:diagnosis and treatment recommendations. J Urol,2005,173:1991-2000.
[2]李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36(02)：124-126.
[3]曾国华,钟文,李逊,等.一期多通道微创经皮肾穿刺取石术治疗鹿角状结石.中华泌尿外科杂志,2007,4：250-252.
[4]徐桂彬,李逊,何朝辉,等.微创经皮肾镜取石术出血量影响因素的分析.中华泌尿外科杂志,2007,7：456-459.
[5]Ferroud V, Lapouge O, Dousseau A, et al. Flexible ureteroscopy and mini percutaneous nephrolithotomy in the treatment of renal lithiasis less or equal to 2 cm. Prog Urol,2011,21(2):79-84.
[6]Guibin Xu, Xun Li, Yongzhong He, et al. Staged single-tract minimally invasive percutaneous nephrolithotomy and flexible ureteroscopy in the treatment of staghorn stone in patients with solitary kidney. Urological Research,2012,40(6):745-749.
[7]那彦群.中国泌尿外科疾病诊断治疗指南.北京：人民卫生出版社,2007：175-8.
[8]Aron M, Yadav R, Goel R, et al. Multi-tract percutaneous nephrolithotomy for large complete staghorn calculi. Urol Int,2005,75(4):327-32.
[9]Wang Y, Jiang F, Wang Y, et al. Post-percutaneous nephrolithotomy septic shock and severe hemorrhage:a study of risk factors. Urol Int,2012,88:307-10.
[10]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study. J Endourol,2004,18:715-22.
[11]El-Nahas AR, Shokeir AA, El-Assmy AM, et al. Post-percutaneous nephrolithotomy extensive hemorrhage:a study of risk factors. J Urol, 2007,177:576-9.
[12]Lahme S, Bichler KH, Strohmaier WL, et al. Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol,2001,40:619-24.
[13]Li SK, Tai D, Chau L, Fung B. Minimally invasive percutaneous nephrolithotomy (MPCNL) according to the Chinese method. In:Baba S, Ono Y, eds. Recent Advances in Endourology. New York:Springer,2006,8, pp. 41-63.
[14]Li Xun, He Zhaohui, Wu Kaijun, et al. Chinese minimally invasive percutaneous nephrolithtomy:the Guangzhou experience. J Endourol,2009, 23(10):1693-7.
[15]李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36：124-6.
[16]曾国华,钟文,李逊,等.一期多通道微创经皮肾穿刺取石术治疗鹿角状结石.中华泌尿外科杂志,2007,28(4)：250-252.
[17]Landman J, Venkatesh R, Lee DI, Rehman J, et al. Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy. J Urol,2003,169(1):64-67.
[18]Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 96(7):1097-1100.
[19]李逊,徐桂彬,何永忠,等.单通道经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石疗效观察(附79例报告).临床泌尿外科杂志.2012,27(6)：452-454.
[20]Handa RK, Evan AP, Willis LR, et al. Renal functional effects of multiple-tract percutaneous access. J Endourol,2009,23(12):1951-6.
[1]Alken P, Hutschenreiter G, Guenther R. Percutaneous kidney stone removal. Eur Urol 1982;8:304-11.
[2]Segura JW, Patterson DE, LeRoy AJ, et al. Percutaneous removal of kidney stones:review of 1,000 cases. J Urol 1985;134:1077-81.
[3]Rassweiler J, Gumpinger R, MIller K, et al. Multimodal treatment (extracorporeal shock wave lithotripsy and endourology) of complicated renal stone disease. Eur Urol 1986; 12:294-304.
[4]Chaussy C, Schmiedt E, Jocham D, et al. First clinical experience with extracorporeally induced destruction of kidney stones by shock waves.J Urol 1982; 127:417-20.
[5]Segura JW. The role of percutaneous surgery in renal and ureteral stone removal. J Urol 1989; 141:780-1.
[6]Rassweiler J, Alken P. ESWL 90-state of the art:limitations and future trends of shock wave lithotripsy. Urol Res 1990; 18:13-24.
[7]Rassweiler JJ, Renner C, Chaussy C, et al. Treatment of renal stones by extracorporeal shock wave lithotripsy. Eur Urol 2001;40:54-64.
[8]Hafron J, Fogarty JD, Boczko D, et al. Combined ureterorenoscopy and shockwave lithotripsy for large renal stone burden:an alternative to percutaneous nephrolithotomy. J Endourol 2005; 19:464-8.
[9]Marguet CG, Springhart WP, Tan YH, et al. Simultaneouscombined use of flexible ureteroscopy and percutaneousnephrolithotomy to reduce the number of access tracts inthe management of complex renal calculi. BJU Int2005;96:1097-100.
[10]Tiselius HG Stone incidence and prevention. Braz J Urol,2000,26(5): 452-462.
[11]Litwin MS, Saigal CS, Yano EM, et al. Urologic diseases in America Project: analytical methods and principal findings. J Urol,2005,173(3):933-937.
[12]孙伟桂,丁智仁,张峻,等.广西地区尿石症患者年龄分布曲线特征及临床意义.中华泌尿外科杂志,2001,22(2)：100-102.
[13]叶章群,邓耀良,董诚主编.泌尿系结石[M].北京：人民卫生出版社,2003.
[14]那彦群.中国泌尿外科疾病诊断治疗指南.北京：人民卫生出版社,2007：175-8.
[15]Preminger GM, Assimos DG, Lingeman JE, el al. Chapter1:AUA guideline on m anagem ent of staghorn calculi:diagnosis and treatment recommendations. J Urol,2005,173:1991-2000.
[16]Tiselius HG, Ackermann D, Alken P, et al. Guidelines on Urolithiasis[J]. In: EAU guidelines. EAU,2006,5-6.
[17]Rupel E, Brown R. Nephroscopy with removal of stone following nephrostomy for obstructive calculous anuria. J Urol.1941,46:177-9.
[18]Goodwin WE, Casey WC, Woolf W. Percutaneous trocar (needle) nephrostomy in hydronephrosis. JAMA.1955,157:891-4.
[19]Fernstrom I, Johansson B. Percutaneous pyelolithotomy. A new extractiontechnique. Scand J Urol Nephrol.1976,10:257-9.
[20]Wickham JE, Kellett MJ. Percutaneous nephrolithotomy. Br J Urol.1981, 53:297-9.
[21]Smith AD, Reinke DB, Miller RP, et al. Percutaneous nephrostomy in the management of ureteral and renal calculi. Radiology,1979,133:49-54.
[22]Gunther R, AlkenP.Percutaneous Nephrostomy in Obstructive Uropathy. Radiology Today,1983,2:94-100.
[23]Alken P, Hutschenreiter G, Gunther R, et al. Percutaneous stone manipulation. J Urol.1981,125:463-6.
[24]Segura JW, Patterson DE, LeRoy AJ, et al. Percutaneous removal of kidney stones:preliminary report. Mayo Clin Proc. 987,57:615-9.
[25]Marberger M, Steckl W, Hruby W. Percutaneous litho-lapaxy of renal calculi with ultrasound. Eur Urol.1982,8:236-42.
[26]叶章群.中国泌尿外科疾病诊断治疗指南／尿石症诊治指南.北京：人民卫生出版社,2010.
[27]Stoller ML, Wolf JS, St Lezin MA. Estimated blood loss and transfusionrates associated with percutaneous nephrolithotomy. J Urol1994;152:1977.
[28]Martin X, Tajra LC, Aboutaieb R, et al. Complete staghorn stones:Percutaneous approach using one or multiple percutaneous accesses.J Endourol 1999; 13:367.
[29]Streem SB. Long-term incidence and risk factors for recurrent stonesfollowing percutaneous nephrostolithotomy or percutaneous nephrostolithotomy/ extracorporeal shock wave lithotripsy for infection relatedcalculi. J Urol 1995;153:584-7.
[30]Tiselius HG, Ackermann D, Alken P, Buck C, Conort P, Gallucci M.Working Party on Lithiasis. European Association of Urology. EurUrol 2001;40(4):362-71.
[31]Albala DM, Assimos DG, Clayman RV, Denstedt JD, Grasso M,Gutierrez-Aceves J, et al. A prospective randomized trial of extracorporealshock wave lithotripsy and percutaneous nephrostolithotomy forlower pole nephrolithiasis: initial results. J Urol 2001; 166:2072-80.
[32]Fuchs GJ, Yurkanin JP. Endoscopic surgery for renal calculi. Cur OpinUrol 2003; 13:243-7.
[33]Hollenbeck BK, Schuster TG, Faerber GJ, Wolf JS. Flexible ureteroscopyin conjunction with in situ lithotripsy for lower pole calculi.Urology 2001;58(6):859-63.
[34]Canales B, Mogna M. Surgical management of the calyceal diverticulum.Curr Opin Urol 2003;13(3):255-60.
[35]Monga M, Smith R, Ferral H, et al. Percutaneous ablation of calicealdiverticulum:long-term followup. J Urol 2000; 163:28-32.
[36]Callaway TW, Lingardh G, Basata S, et al. Percutaneousnephrolithotomyin children. J Urol 1992; 148(3 pt 2):1067-8.
[37]Mor Y, Elmasry YE, Kellett MJ, et al.The role of percutaneousnephrolithotomy in the management of pediatric renal calculi. J Urol1997; 158(3 pt 2):1319-21.
[38]Fraser M, Joyce AD, Thomas DF, et al. Minimallyinvasive treatment of urinary tract calculi in children. BJU Int 1999;84(3):339-42.
[39]Jackman SV, Hedican SP, Peters CA, et al. Percutaneousnephrolithotomy in infants and preschool age children:experiencewith a new technique. Urology 1998;52(4):697-701.
[40]Dawaba MS, Shokeir AA, Hafez AT, et al.Percutaneous nephrolithotomy in children:early andlate anatomical and functional results. J Urol 2004;172(3):1078-1081.
[41]Riedmiller H, Androulakakis P, Beurton D, et al.EAU guidelines on paediatric urology. Eur Urol 2001;40(5):589-99.
[42]Desai M. Endoscopic management of stones in children.Curr Opin Urol 2005;15:107-112.
[43]Woodside JR, Stevens GF, Stark GL, et al. Percutaneousstone removal in children. J Urol 1985;134(6):1166-7.
[44]Raj GV, Auge BK,Weizer AZ, et al. Percutaneous management of calculi within horseshoe kidneys. JUrol 2003;170(1):48-51.
[45]Kupeli B, Isen K, Biri H, et al.Extracorporeal shock wave lithotripsy in anomalous kidneys. JEndourol 1999;13(5):349-52.
[46]Lu HF, Shekarriz B, Stoller ML. Donor-gifted allograft urolithiasis:early percutaneous management. Urology 2002;59(1):25-7.
[47]Ramakumar S, Segura JW. Renal calculi:percutaneous management.Urol Clin North Am 2000;27(4):617-22.
[48]Pearle MS, Nakada SY, Womack JS, et al. Outcomes of contemporarypercutaneous nephrostolithotomy in morbidly obesepatients. J Urol 1998;160(3 pt 1):669-73.
[49]Koo BC, Burtt G, Burgess NA. Percutaneous stone surgery in theobese: outcome stratified according to body mass index. BJU Int 2004;93(9):1296-9.
[50]El-Assmy AM. Outcome of Percutaneous Nephrolithotomy:Effect of Body Mass Index,Eur Urol (2006), doi:10.1016
[51]Netto Junior N, Lemos GC, Fiuza JL. Percutaneous nephrolithotomyin patients with previous renal surgery. Eur Urol 1988;14(5):353-5.
[52]Basiri A, Karrami H, Moghaddam SM, et al. Percutaneousnephrolithotomy in patients with or without a history of open nephrolithotomy.J Endourol 2003; 17(4):213-6.
[53]Helal M, Black T, Lockhart J, et al. The Hickman peel-away sheath:alternative for pediatric percutaneous nephrolithotomy. J Endourol.1997,11:171-2.
[54]Jackman SV, Docimo SG, Cadeddu JA, et al. The'mini-perc' technique:a less invasive alternative to percutaneous nephrolithotomy. World J Urol.1998,16:371-4.
[55]Monga M, Oglevie S. Minipercutaneous nephrolithotomy. J Endourol.2000, 14:419-21.
[56]Lahme S, Bichler KH, Strohmaier WL, et al. Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol.2001,40:619-24.
[57]郭应禄,潘柏年,薛兆英,等.经皮肾镜穿刺取石术.中华外科杂志,1986,24：34-5.
[58]余安迪,王邦宏,吴腾斐,等.经皮穿刺肾石取出术42例初步报告.中华泌 尿外科杂志,1986,7：67-9.
[59]杨运彰,吴开俊,袁坚,等.经皮穿刺肾造痰取石术.中华医学杂志,1986,66：279-81.
[60]吴开俊,李逊,袁坚,等.经皮肾微造瘘术后二期经皮输尿管镜取石术治疗鹿角形结石.广州医学院学报,1993,21：13-5.
[61]李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36：124-6.
[62]Sung YM, Choo SW, Jeon SS, et al. The "mini-perc" technique of percutaneous nephrolithotomy with a 14-Fr peel-away sheath:3-year results in 72 patients.Korean J Radiol.2006,7(1):50-6.
[63]Nagele U, Schilling D, Anastasiadis AG, et al. Minimally invasive percutaneous nephrolitholapaxy (MIP). Urologe A.2008,47(9):1066,1068-73.
[64]Lahme S, Zimmermanns V, Hochmuth A, et al. Minimally invasive PCNL (mini-perc). Alternative treatment modality or replacement of conventional PCNL?.Urologe A.2008,47(5):563-8.
[65]Wah TM, Kidger L, Kennish S, et al. MINI PCNL in a pediatric population. Cardiovasc Intervent Radiol.2013;36(1):249-54.
[66]Zhong W, Zeng G, Wu W, et al.Minimally invasive percutaneous nephrolithotomy with multiple mini tracts in a single session in treating staghorn calculi. Urol Res.2011;39(2):117-22.
[67]李逊,徐桂彬,何永忠,等.微创经皮肾取石术治疗孤立肾铸型结石的疗效观察.临床泌尿外科杂志,2009,24：653-5.
[68]Maurice SM, Lutz T, Jens JR. Complications in Percutaneous Nephrolithotomy. Eur Urol,2006,10.1016.
[69]Valdivia Uria JG, Valle Gerhold J, Lopez Lopez JA, et al. Techniqueand complications of percutaneous nephroscopy:experience with 557patients in the supine position. J Urol 1998;160(6 Pt 1):1975-8.
[70]Desai M, Ridhorkar V, Patel S, et al. Pediatricpercutaneous nephrolithotomy: assessing impact of technical innovations on safety and efficacy. J Endourol 1999; 13:359-64.
[71]Ng MT, Sun WH, Cheng CW, et al. Supine positionis safe and effective for percutaneous nephrolithotomy.J Endourol 2004; 18:469-74
[72]Shoma AM, Eraky I, El-Kenawy MR, et al. Percutaneousnephrolithotomy in the supine position:technical aspects and functionaloutcome compared with the prone technique. Urology 2002;60:388-92.
[73]Matlaga BR, Shah OD, Zgoria RJ, et al.Computerized tomography guided access for percutaneous nephrolithotomyJ Urol 2003; 170:45-7.
[74]Munver R, Delvechio F, Newman G, et al. Critical analyses ofsupracostal access for percutaneous renal surgery. J Urol 2001;166:1242-6.
[75]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study.J Endourol.2004 Oct;18(8):715-22.
[76]Munver R, Delvechio F, Newman G, et al. Critical analyses ofsupracostal access for percutaneous renal surgery. J Urol 2001;166:1242-6.
[77]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study.J Endourol.2004 Oct;18(8):715-22.
[78]Kim SC, Kuo RL, Lingeman JE. Percutaneous nephrolithotomy:anupdate. Curr Opin Urol 2003;13:235-41.
[79]Allen P, Hutschenreiter G, Gunther R, et al. Percutaneousstone manipulation. J Urol 1981;125:463-7.
[80]Segura JW, Patterson DE, Leroy AJ, et al. Percutaneouslithotripsy. J Urol 1983;130:1051-4.
[81]Clayman RV, Castaneda-Zuniga WR, Hunter J, et al. Rapid balloon dilatation of the nephrostomy track fornephrostolithotomy. Radiology 1983;147:884-5.
[82]Davidoff R, Bellman G Influence of technique of percutaneous tractcreation on incidence of renal hemorrhage. J Urol 1997; 157:1229-31.
[83]Safak M, Gogus C, Soygur T. Nephrostomy tract dilation using aballoon dilator in percutaneous renal surgery:experience with 95 casesand comparison with the fascial dilator system. Urol Int 2003;71(4):382-4.
[84]Bellman GC, Davidoff R. Influence of technique of percutaneoustract creation on incidence of renal hemorrhage. J Urol1997;157:1229.
[85]徐桂彬,李逊,何永忠,等.微创肾镜与输尿管镜在微创经皮肾穿刺取石术治疗上尿路结石中的对比研究.临床泌尿外科杂志.2011,3：172-173.
[86]徐桂彬,李逊,何永忠,等.微创经皮肾镜取石术联合负压装置一期治疗结石性脓肾的疗效分析.中华泌尿外科杂志,2013,34：93-95.
[87]Desai MR, Sharma R, Mishra S, et al. Single-step percutaneous nephrolithotomy (microperc):the initial clinical report.J Urol. 2011;186(1):140-5.
[88]Landman J, Venkatesh R, Lee DI, Rehman J, et al. Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy. J Urol,2003,169(l):64-67.
[89]Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 96(7):1097-1100.
[90]Guibin Xu, Xun Li, Yongzhong He, et al. Staged single-tract minimally invasive percutaneous nephrolithotomy and flexible ureteroscopy in the treatment of staghorn stone in patients with solitary kidney. Urological Research.2012,40(6):745-749.
[91]李逊,徐桂彬,何永忠,等.单通道经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石疗效观察(附79例报告).临床泌尿外科杂志.2012,27(6)：452-454.
[92]Lawson RK, Murphy JB, Taylor AJ, et al. Retrograde method for percutaneous access to kidney. Urology,1983,22:580-582.
[93]Hunter PT, Finlayson B, Drylie DM, et al. Retrograde nephrostomy and percutaneous calculus removal in 30 patients. J Urol,1985,133:369-374.
[94]Kawahara T, Matsuzaki J, Kubota Y. Ureteroscopy-assisted retrograde nephrostomy for an obese patient. Indian J Urol.2012 Oct;28(4):439-41.
[95]Takashi Kawahara, Hiroki Ito, Hideyuki Terao, et al. Effectiveness of Ureteroscopy-Assisted Retrograde Nephrostomy (UARN) for Percutaneous Nephrolithotomy (PCNL). PLoS One.2012; 7(12):e52149.
[96]Lee WJ, Smith AD, Cubelli V, Badlani GH., et al. Complications of percutaneous nephrolithotomy. AJR,148:177,1987.
[97]RothRA, Beckmann CF.Complications of extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy. Urol. Clin. N. Amer.,15:155,1988.
[98]CarsonCC. Complications of percutaneous stone extraction:prevention and treatment. Sem. Urol.,4:161,1986.
[99]Clayman RV, Hunter D, Surya V, ea al.Percutaneous intrarenal electrosurgery. J. Urol,131:864,1984.
[100]Gavant ML, Gold RE, Church JC. Delayed rupture of renal pseudoaneurysm: complication of percutaneous nephrostomy. AJR,138:948,1982.
[101]Cope C, Zeit RM. Pseudoaneurysms after nephrostomy. AJR,139:255,1982.
[102]Segura JW, Preminger GM, Assimos DG, et al. NephrolithiasisClinical Guidelines Panel Summary Report on the Management ofStaghorn Calculi. J Urol 1994;151:1648.
[103]Rodrigues Netto, N Jr. Lemos, G C. Palma, P C. Fiuza, J L. Staghorn calculi: percutaneous versus anatrophic nephrolithotomy. European Urology. 15(1-2):9-12,1988.
[104]Kessaris DN, Bellman GC, Pardalidis NP, Smith AD. Managementof hemorrhage after percutaneous renal surgery. J Urol 1995;153:604.
[105]Stoller ML, Wolf JS, St Lezin MA. Estimated blood loss and transfusionrates associated with percutaneous nephrolithotomy. J Urol 1994; 152:1977.
[106][83].Kahnoski RJ, Lingeman JE, Coury TA, Steele RE, Mosbaugh PG.Combined percutaneous and extracorporeal shock wave lithotripsyfor staghorn calculi:An alternative to anatrophic nephrolithotomy.J Urol 1986;135:679.
[107]Snyder JA, Smith AD. Staghorn calculi:Percutaneous extractionversus anatrophic nephrolithotomy. J Urol 1986; 131:351.
[108]Puttipannee V, Krisana P, Em-Orn R, et al. Perioperative complications and risk factors of percutaneous nephrolithotomy. J Med Assoc Thai 89(6),2006.
[109]DoganHS, SahinA,CetinkayaY,AkdoganB,OzdenE,KendiS. Antibiotic prophylaxis in percutaneous nephrolithotomy:prospective study in 81 patients. J Endourol2002; 16:649-53.
[110]Aron M, Yadav R, Goel R, et al. Multi-tract percutaneousnephrolithotomy for large complete staghorn calculi. UrolInt 2005;75:327-32.
[111]Vorrakitpokatorn P, Permtongchuchai K, Raksamani EO,Phettongkam A. Perioperative complications and risk factorsof percutaneous nephrolithotomy. J Med Assoc Thai2006;89:826-33.
[112]Ichel MS, et al.Complications in Percutaneous Nephrolithotomy, Eur Urol (2006),10-020.
[113]Shaw, G. Wah, T M. Kellett, M J. Choong, S K S. Management of renal-vein perforation during a challenging percutaneous nephrolithotomy. Journal of Endourology.19(6):722-3,2005 Jul-Aug.
[114]Pardalidis NP, Smith AD. Complications of percutaneous renal procedures.In: Controversies in Endourology. Philadelphia:WB Saunders,1995, p 179.
[115]Liatsikos EN, Kapoor R, Lee B, Jabbour M, Barbalias G,Smith AD. "ngular percutaneous renal access".Multiple tracts through a single incision for staghorncalculous treatment in a single session. Eur Urol2005;48:832-7.
[116]Gupta R, Kumar A, Kapoor R, Srivastava A, Mandhani A.Prospective evaluation of safety and efficacy of thesupracostal approach for percutaneous nephrolithotomy.BJU Int 2002;90:809-13.
[117]E1-Nahas AR, Shokeir AA, El-Assmy AM, et al. Colonicperforation during percutaneous nephrolithotomy:studyof risk factors. Urology 2006;67:937-41.
[118]Gerspach JM, Bellman GC, Stoller ML, Fugelso P. Conservativemanagement of colon injury following percutaneousrenal surgery. Urology 1997;49:831-6.
[119]Vallancien G, Capdeville R, Veillon B, Charton M, BrissetJM. Colonic perforation during percutaneous nephrolithotomy.J Urol 1985; 134:1185-7.
[120]Takeuchi H, Ueda M, Nonomura M, et al. Fever attack inpercutaneous nephrolithotomy and transurethral ureterolithotripsy.Hinyokika Kiyo 1987;33:1357-63.
[121]李逊.经皮肾镜取石术的微创理念.中华腔镜泌尿外科杂志(电子版).2010,4(3)：176-179.
2. Litwin MS, Saigal CS, Yano EM, et al. Urologic diseases in America Project: analytical methods and principal findings. J Urol,2005,173(3):933-937.
3.孙伟桂,丁智仁,张峻,等.广西地区尿石症患者年龄分布曲线特征及临床意义.中华泌尿外科杂志,2001,22(2)：100-102.
4.叶章群,邓耀良,董诚主编.泌尿系结石[M].北京：人民卫生出版社,2003.
5.邓耀良,复杂性肾结石的外科治疗.临床泌尿外科学杂志,2006,21(2)：81-84.
6.那彦群.中国泌尿外科疾病诊断治疗指南.北京：人民卫生出版社,2007：175-8.
7. Preminger GM, Assimos DG, Lingeman JE, el al. Chapterl:AUA guideline on m anagem ent of staghorn calculi:diagnosis and treatment recommendations. J Urol, 2005,173:1991-2000.
8. Tiselius HG, Ackermann D, Alken P, et al. Guidelines on Urolithiasis[J]. In:EAU guidelines. EAU,2006,5-6.
9. Rupel E, Brown R. Nephroscopy with removal of stone following nephrostomy for obstructive calculous anuria. J Urol,1941,46:177-9.
10. Goodwin WE, Casey WC, Woolf W. Percutaneous trocar (needle) nephrostomy in hydronephrosis. JAMA,1955,157:891-4.
11. Fernstrom I, Johansson B. Percutaneous pyelolithotomy. A new extractiontechnique. Scand J Urol Nephrol,1976,10:257-9.
12. Wickham JE, Kellett MJ. Percutaneous nephrolithotomy. Br J Urol,1981, 53:297-9.
13. Smith AD, Reinke DB, Miller RP, et al. Percutaneous nephrostomy in the management of ureteral and renal calculi. Radiology,1979,133:49-54.
14. Gunther R, AlkenP.Percutaneous Nephrostomy in Obstructive Uropathy. Radiology Today,1983,2:94-100.
15. Alken P, Hutschenreiter G, Gunther R, et al. Percutaneous stone manipulation. J Urol.1981,125:463-6.
16. Segura JW, Patterson DE, LeRoy AJ, et al. Percutaneous removal of kidney stones:preliminary report. Mayo Clin Proc.1987,57:615-9.
17. Marberger M, Steckl W, Hruby W. Percutaneous litho-lapaxy of renal calculi with ultrasound. Eur Urol.1982,8:236-42.
18.叶章群.中国泌尿外科疾病诊断治疗指南/尿石症诊治指南.北京：人民卫生出版社,2010.
19. Helal M, Black T, Lockhart J, et al. The Hickman peel-away sheath:alternative for pediatric percutaneous nephrolithotomy. J Endourol.1997,11:171-2.
20. Jackman SV, Docimo SG, Cadeddu JA, et al. The'mini-perc'technique:a less invasive alternative to percutaneous nephrolithotomy. World J Urol. 1998,16:371-4.
21. Monga M, Oglevie S. Minipercutaneous nephrolithotomy. J Endourol.2000, 14:419-21.
22. Lahme S, Bichler KH, Strohmaier WL, et al. Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol.2001,40:619-24.
23.郭应禄,潘柏年,薛兆英,等.经皮肾镜穿刺取石术.中华外科杂志,1986,24：34-5.
24.余安迪,王邦宏,吴腾斐,等.经皮穿刺肾石取出术42例初步报告.中华泌尿外科杂志,1986,7：67-9.
25.杨运彰,吴开俊,袁坚,等.经皮穿刺肾造痰取石术.中华医学杂志,1986, 66：279-81.
26.吴开俊,李逊,袁坚,等.经皮肾微造瘘术后二期经皮输尿管镜取石术治疗鹿角形结石.广州医学院学报,1993,21：13-5.
27.李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36：124-6.
28. Li SK, Tai D, Chau L, Fung B. Minimally invasive percutaneous nephrolithotomy (MPCNL) according to the Chinese method. In:Baba S, Ono Y, eds. Recent Advances in Endourology. New York:Springer,2006,8, pp.41-63.
29. Fanardzhian SV. Complications of percutaneous nephrolithotripsy in staghorn nephrolithiasis. Georgian Med News.2010, (187):7-12.
30. Rudnick DM, Stoller ML. Complications of percutaneousnephrostolithotomy. Can J Urol 1999;6:872-5.20
31. Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy.Eur Urol,2007,51 (4):899-906.
32. Pardalidis NP, Smith AD. Complications of percutaneous renal procedures.In: Controversies in Endourology. Philadelphia:WB Saunders,1995, p 179.
33. Kessaris DN, Bellman GC, Pardalidis NP, Smith AD. Managementof hemorrhage after percutaneous renal surgery. J Urol 1995; 153:604.
34. Stoller ML, Wolf JS, St Lezin MA. Estimated blood loss and transfusionrates associated with percutaneous nephrolithotomy. J Urol 1994; 152:1977.
35. Netto R, Lemos GC, Palma PC, Fiuza JL. Staghorn calculi:Percutaneousversus anatrophic nephrolithotomy. Eur Urol 1988; 15:9.
36. Kahnoski RJ, Lingeman JE, Coury TA, Steele RE, Mosbaugh PGCombined percutaneous and extracorporeal shock wave lithotripsyfor staghorn calculi:An alternative to anatrophic nephrolithotomyJ Urol 1986; 135:679.
37. Snyder JA, Smith AD. Staghorn calculi:Percutaneous extractionversus anatrophic nephrolithotomy. J Urol 1986; 131:351.
38. Schulze H, Hertle L, Kumpf HP, et al. Critical evaluation of treatmentof staghorn calculi by percutaneous nephrolithotomy and extracorporealshock wave lithotripsy. J Urol 1989; 141:822.
39. Assimos DG, Wrenn JJ, Harrison LH, et al. A comparison of anatrophicnephrolithotomy and percutaneous nephrolithotomy withand without extracorporeal shock wave lithotripsy for managementof patients with staghorn calculi. J Urol 1991; 145:710.
40. Lam HS, Lingeman JE, Baccon, M, et al. Staghorn calculi:Analysisof treatment results between initial percutaneous ephrostolithotomyand extracorporeal shock wave lithotripsy monotherapywith reference to surface area. J Urol 1992;147:1219.
41. Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study. J Endourol,2004,18: 715-722.
42.徐桂彬,李逊,何朝辉,等.微创经皮肾镜取石术出血量影响因素的分析.中华泌尿外科杂志,2007,7：456-459.
43.李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36(02)：124-126.
44.曾国华,钟文,李逊,等.一期多通道微创经皮肾穿刺取石术治疗鹿角状结石.中华泌尿外科杂志,2007,4：250-252.
45. Marshall VF. Fiber optics in urology. Urology,1964,91:110-111.
46. Takagi T, Go T, Takayasu H, Aso Y. Fiberoptic pyeloureteroscope. Surgery, 1971,70(5):661-663.
47. Bagley Dh, Huffman Jl, Lyon Es. Combined rigid and flexible ureteropyeloscopy. J Urol,1983,130:243-244.
48. Razvan M, Bogdan G, Dragos G, et al. Conventional Fiberoptic Flexible Ureterscope Versus Fourth Generation Distal Flexible Ureteroseope:A Critical Comparison.2010,21(1):17-21.
49. Watson Gm, Wickham Jea. Initial experience with a pulsed dye laser for ureteric calculi. Lancet 1986; i:1357-1358.
50. Sofer M, Watterson JD, Wollin TA, ea al. Holmium:YAG lithotripsy for upper urinary tract calculi in 598 patients. J Urol,2002,167:31-34.
51.孙颖浩,戚晓升,王林辉,等.输尿管软镜下钬激光碎石术治疗肾盏结石.临床泌尿外科杂志,2004,19(3)：139-141.
52. Defidio L, Dominicis M. Flexible ureteroscopy for kidney stones in children. Arch Ital Urol Androl.2010,82(1):53-55.
53. Abdel-Razzak OM, Bagley DH.Clinical experience with flexible ureteropyeloscopy. J Urol.1992,148(6):1788-1792.
54. Auge BK, Dahm P, Wu NZ, Preminger GM. Ureteroscopicmanagement of lower-pole renal calculi:Technique of calculus displacement. J Endourol, 2001,15:835-838.
55. Breda A, Ogunyemi O, Leppert JT, et al. Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater--is this the new frontier? J Urol,2008,179(3):981-984.
56. Hyams ES, Munver R, Bird VQ et al. Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm:a multi-institutional experience. J Endourol,2010,24(10):1583-1588.
57. Knudsen B, Miyaoka R, Shah K, et al. Durability of the next generation flexible flberoptic ureteroscopes:a randomized prospectire multi-institutional clinical trial. Urology,2010,75:534-538.
58. Landman J, Venkatesh R, Lee DI, Rehman J, et al. Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy. J Urol,2003,169(1):64-67.
59. Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 96(7):1097-1100.
[1]Fernstrom I, Johansson B. Percutaneous pyelolithotomy. A new extraction technique. Scand J Urol Nephrol,1976,10:257-9.
[2]Matlaga BR, Kim SC, Lingeman JE. Improving outcomes of percutaneous nephrolithotomy:Access. EAU Update Series,2005,3:37-43.
[3]Raj GV, Auge BK, Weizer AZ, et al. Percutaneous management of calculi within horseshoe kidneys. J Urol,2003,170:48-51.
[4]Jackman SV, Docimo SG, Cadeddu JA, et al. The'mini-perc'technique:a less invasive alternative to percutaneous nephrolithotomy. World J Urol,1998,16:371-4.
[5]李逊,曾国华,吴开俊.微创经皮肾穿刺取石术治疗上尿路结石.临床泌尿外科杂志,2003,18(9)：516-518.
[6]李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36(2)：124-126.
[7]叶章群.中国泌尿外科疾病诊断治疗指南/尿石症诊治指南.北京：人民卫生出版社,2010.
[8]Preminger GM, Assimos DG, Lingeman JE, et al. Chaptel 1:AUA guideline om management of staghorn calculi:diagnosis and treatment recommendations. J Urol,2005,173:1991-2000.
[9]李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36(2)：124-126.
[10]曾国华,钟文,李逊,等.一期多通道微创经皮肾穿刺取石术治疗鹿角状结石.中华泌尿外科杂志,2007,4：250-252).
[11]徐桂彬,李逊,何朝辉,等.微创经皮取石术出血量影响因素的分析.中华 泌尿外科杂志,2007,28(07)：456-459.
[12]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study. J Endourol,2004, 18(8):715-722.
[13]Hussain M, Archer P, Penev B, et al. Redefining the limits of flexible ureterorenoscopy. J Endourol,2010,25(1):45.
[14]Prabhakar M. Retrograde ureteroscopic intrarenal surgery for large (1.6-3.5 cm) upper ureteric/renal calculus. Indian J Urol,2010,26(1):46-49.
[15]Xun Li, Zhaohui He, Kaijun Wu, et al. Chinese Minimally Invasive Percutaneous Nephrolithotomy:The Guangzhou Experience. J Endourol,2010, 25(9):1421-5.
[16]Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 96(7):1097-1100.
[1]Preminger GM, Assimos DG, Lingeman JE, et al. Chaptel 1:AUA guideline om management of staghorn calculi:diagnosis and treatment recommendations. J Urol,2005,173:1991-2000.
[2]Abdel-Razzak OM, Bagley DH. Clinical experience with flexible ureteropyeloscopy. J Urol,1992,148(6):1788-1792.
[3]Landman J, Venkatesh R, Lee Dl, et al. Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy. J Urol,2003,169:64-7.
[4]李逊,徐桂彬,何永忠,等.单通道经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石疗效观察(附79例报告).临床泌尿外科杂志,2012,27(6)：452-454.
[5]Desai M, Ganpule A, Monahar T. "Multiperc" for complete staghorn calculus[J]. J Endourol 2008,22:1831-1841.
[6]徐桂彬,李逊,何朝辉,等.微创经皮取石术出血量影响因素的分析.中华泌尿外科杂志,2007,28(07)：456-459.
[7]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study. J Endourol,2004,18(8): 715-722.
[8]Breda A, Ogunyemi O, Leppert J, et al. Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater-is this the new frontier?. J Urol,2008,179(3):981-984.
[9]Hussain M, Archer P, Penev B, et al. Redefining the limits of flexible ureterorenoscopy. J Endourol,2010,25(1):45.
[10]Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 96(7):1097-1100.
[11]Guibin Xu, Xun Li, Yongzhong He, et al. Staged single-tract minimally invasive percutaneous nephrolithotomy and flexible ureteroscopy in the treatment of staghorn stone in patients with solitary kidney. Urological Research,2012,40(6):745-749.
[1]叶章群.尿石症诊断治疗指南.见：那彦群,主编.中国泌尿外科疾病诊断治疗指南.北京：人民生出版社,2007,267.
[2]叶向东,梁志雄.多通道微创经皮肾取石术治疗孤立肾肾结石.中国医师杂志.2006,2：205-206.
[3]朱建国,王元林,杨秀书,等.微创经皮肾镜取石术治疗孤立肾合并肾结石.中国内镜杂志,2006,11：2010-2012.
[4]颜冰,付杰新,谢光宇,等.微创经皮肾镜取石术治疗孤立肾肾结石.基层医学论坛.2008,12：484-486.
[5]刘星明,任胜强,邬旭明,等.微创经皮肾镜取石术治疗孤立肾肾结石(26例报告).临床泌尿外科杂志,2007,3：177-178.
[6]李逊,徐桂彬,何永忠,等.微创经皮肾取石术治疗孤立肾铸型结石的疗效观察.临床泌尿外科杂志,2009,24：653-5.
[7]Fernstrom I, Johansson B. Percutaneous pyelolithotomy:a new extraction technique. Scand J Urol Nephrol,1976,10(3):257-259.
[8]Fanardzhian SV. Complications of percutaneous nephrolithotripsy in staghorn nephrolithiasis. Georgian Med News,2010,187:7-12.
[9]Rudnick DM, Stoller ML. Complications of percutaneous nephrostolithotomy. Can J Urol,1999,6:872-520
[10]Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. Eur Urol,2007,51(4):899-906.
[11]Li X, He Z, Wu K, Li SK, et al. Chinese minimally invasive percutaneous nephrolithotomy:the Guangzhou experience. J Endourol,2009, 23(10):1693-1697.
[12]Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 96(7):1097-1100.
[13]Zhong W, Zeng G, Wu W, et al. Minimally invasive percutaneous nephrolithotomy with multiple mini tracts in a single session in treating staghorn calculi. Urol Res,2011,39(2):117-122.
[14]Hyams ES, Munver R, Bird VG, et al. Flexible ureterorenoscopy and holmium laser lithotripsy for the management of renal stone burdens that measure 2 to 3 cm:a multi-institutional experience. J Endourol,2010,24(10):1583-1588.
[15]Preminger GM, Assimos DG, Lingeman JE, el al. Chapterl:AUA guideline on management of staghorn calculi:diagnosis and treatment recommendations. J Urol,2005,173:1991-2000.
[16]Liatsikos EN, Kallidonis P, Stolzenburg JU, et al. Percutaneous management of staghorn calculi in horseshoe kidneys:a multi-institutional experience. J Endourol,2010,24(4):531-536.
[17]Resorlu B, Kara C, Oguz U, et al. Percutaneous nephrolithotomy for complex caliceal and staghorn stones in patients with solitary kidney. Urol Res,2011, 39(3):171-176.
[18]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study. J Endourol,2004,18(8): 715-722.
[19]El-Nahas AR, Shokeir AA, El-Assmy AM, et al. Post-percutaneous nephrolithotomy extensive hemorrhage:a study of risk factors. J Urol,2007, 177(2):576-579.
[20]Lam HS, Lingeman JE, Mosbaugh PG, et al. Evolution of the technique of combination therapy for staghorn calculi:a decreasing role for extracorporeal shock wave lithotripsy. J Urol,1992,148(3 Pt 2):1058-1062.
[21]Chibber PJ. Percutaneous nephrolithotomy for large and staghorn calculi. J Endourol,1993,7(4):293-295.
[22]Koga S, Arakaki Y, Matsuoka M, et al. Staghorn calculi--long-term results of management. Br J Urol,1991,68(2):122-124.
[23]Breda A, Ogunyemi O, Leppert JT, et al. Flexible ureteroscopy and laser lithotripsy for single intrarenal stones 2 cm or greater--is this the new frontier? J Urol,2008,179(3):981-984.
[24]Landman J, Venkatesh R, Lee DI, Rehman J, et al. Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy. J Urol,2003,169(1):64-67.
[1]Hubert J, Blum A, Cormier L, et al. Three-dimensional CT-scan reconstruction of renal calculi:A new tool for mapping-out staghorn calculi and follow-up of radiolucent stones. Eur Urol,1997,31:297-301.
[2]孟祥军,米其武,等.CT三维重建辅助经皮肾镜术穿刺定位.临床和实验医学杂志,2007,6(6)：55-57.
[3]李逊,孟祥军,曾国华,等.C T三维重建在经皮肾镜取石术中的应用价值.中华泌尿外科杂志,2007,28(6)：379-381.
[4]孙颖浩,高旭,高小峰,等.输尿管软镜下钬激光碎石术治疗肾盏结石.临床泌尿外科杂志,2004,19(3)：139-141.
[5]Geavlete P, Multescu R, Geavelete B, et al. Influence of pyelocaliceal anatomy on the success of flexible ureteroscopi approach. J Endourdl,2008,22(10):22.
[6]Preminger GM, Assimos DG, Lingeman JE, et al. Chaptel 1:AUA guideline om management of staghorn calculi:diagnosis and treatment recommendations. J Urol,2005(173):1991-2000.
[7]Desai M, Ganpule A, Monahar T. "Multiperc" for complete staghorn calculus. J Endourol 2008,22:1831-1841.
[8]徐桂彬,李逊,何朝辉,等.微创经皮取石术出血量影响因素的分析.中华泌尿外科杂志,2007,28(07)：456-459.
[9]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study. J Endourol,2004, 18(8):715-722.
[10]Hussain M, Archer P, Penev B, et al. Redefining the limits of flexible ureterorenoscopy. J Endourol,2010,1:45.
[11]Geavlete P, Aghamiri SA, Multescu R. Retrograde flexible ureteroscopic approach for pyelocaliceal calculi. Urol J,2006,3(1):15-9;
[12]Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 7:1097-1100.
[13]李逊,徐桂彬,何永忠,等.单通道经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石疗效观察(附79例报告).临床泌尿外科杂志,2012,27：452-454.
[14]Geavlete P, Multescu R, Geavelete B, et al. Influence of pyelocaliceal anatomy on the success of flexible ureteroscopy approach. J Endourdl,2008,22(10):22.
[15]Petrisor G, Razvall M, Bogdan G. Influence of pyelocaliceal anatomy on the success of flexible ureteroscopic approach. Journal of endourology.2008, 22(10):2235-2239.
[16]Kumar P, Keeley FX, Timoney AG Retrograde ureteropyeloscopy caliceal calculi. J Urol,2000,164(4):1318.
[17]孙颖浩,戚晓升,王林辉,等.输尿管软镜下钬激光碎石术治疗肾结石(附51例报告).中华泌尿外科杂志,2002,23：681-682.
[18]Grasso M, Bagley D. Small diameter, actively deflectable, flexible ureteropyeloscopy. J Urol,1998,160(5):1648-1653.
[19]Shvarts O,Perry KT, Goff B, et al. Improved functiona 1 deflection with a dual-deflection flexible ureteroscope. J Endourol,2004,18(2):141-144.
[20]Pasqui F, Dubosq F, Tchala K, et al. Impact on active scope deflection and irrigation flow of all endoscopic working tools during flexible ureteroscopy. Eur Urol,2004,45 (1):58-64.
[1]Preminger GM, Assimos DQ Lingeman JE, el al. Chapter1:AUA guideline on m anagem ent of staghorn calculi:diagnosis and treatment recommendations. J Urol,2005,173:1991-2000.
[2]李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36(02)：124-126.
[3]曾国华,钟文,李逊,等.一期多通道微创经皮肾穿刺取石术治疗鹿角状结石.中华泌尿外科杂志,2007,4：250-252.
[4]徐桂彬,李逊,何朝辉,等.微创经皮肾镜取石术出血量影响因素的分析.中华泌尿外科杂志,2007,7：456-459.
[5]Ferroud V, Lapouge O, Dousseau A, et al. Flexible ureteroscopy and mini percutaneous nephrolithotomy in the treatment of renal lithiasis less or equal to 2 cm. Prog Urol,2011,21(2):79-84.
[6]Guibin Xu, Xun Li, Yongzhong He, et al. Staged single-tract minimally invasive percutaneous nephrolithotomy and flexible ureteroscopy in the treatment of staghorn stone in patients with solitary kidney. Urological Research,2012,40(6):745-749.
[7]那彦群.中国泌尿外科疾病诊断治疗指南.北京：人民卫生出版社,2007：175-8.
[8]Aron M, Yadav R, Goel R, et al. Multi-tract percutaneous nephrolithotomy for large complete staghorn calculi. Urol Int,2005,75(4):327-32.
[9]Wang Y, Jiang F, Wang Y, et al. Post-percutaneous nephrolithotomy septic shock and severe hemorrhage:a study of risk factors. Urol Int,2012,88:307-10.
[10]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study. J Endourol,2004,18:715-22.
[11]El-Nahas AR, Shokeir AA, El-Assmy AM, et al. Post-percutaneous nephrolithotomy extensive hemorrhage:a study of risk factors. J Urol, 2007,177:576-9.
[12]Lahme S, Bichler KH, Strohmaier WL, et al. Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol,2001,40:619-24.
[13]Li SK, Tai D, Chau L, Fung B. Minimally invasive percutaneous nephrolithotomy (MPCNL) according to the Chinese method. In:Baba S, Ono Y, eds. Recent Advances in Endourology. New York:Springer,2006,8, pp. 41-63.
[14]Li Xun, He Zhaohui, Wu Kaijun, et al. Chinese minimally invasive percutaneous nephrolithtomy:the Guangzhou experience. J Endourol,2009, 23(10):1693-7.
[15]李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36：124-6.
[16]曾国华,钟文,李逊,等.一期多通道微创经皮肾穿刺取石术治疗鹿角状结石.中华泌尿外科杂志,2007,28(4)：250-252.
[17]Landman J, Venkatesh R, Lee DI, Rehman J, et al. Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy. J Urol,2003,169(1):64-67.
[18]Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 96(7):1097-1100.
[19]李逊,徐桂彬,何永忠,等.单通道经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石疗效观察(附79例报告).临床泌尿外科杂志.2012,27(6)：452-454.
[20]Handa RK, Evan AP, Willis LR, et al. Renal functional effects of multiple-tract percutaneous access. J Endourol,2009,23(12):1951-6.
[1]Alken P, Hutschenreiter G, Guenther R. Percutaneous kidney stone removal. Eur Urol 1982;8:304-11.
[2]Segura JW, Patterson DE, LeRoy AJ, et al. Percutaneous removal of kidney stones:review of 1,000 cases. J Urol 1985;134:1077-81.
[3]Rassweiler J, Gumpinger R, MIller K, et al. Multimodal treatment (extracorporeal shock wave lithotripsy and endourology) of complicated renal stone disease. Eur Urol 1986; 12:294-304.
[4]Chaussy C, Schmiedt E, Jocham D, et al. First clinical experience with extracorporeally induced destruction of kidney stones by shock waves.J Urol 1982; 127:417-20.
[5]Segura JW. The role of percutaneous surgery in renal and ureteral stone removal. J Urol 1989; 141:780-1.
[6]Rassweiler J, Alken P. ESWL 90-state of the art:limitations and future trends of shock wave lithotripsy. Urol Res 1990; 18:13-24.
[7]Rassweiler JJ, Renner C, Chaussy C, et al. Treatment of renal stones by extracorporeal shock wave lithotripsy. Eur Urol 2001;40:54-64.
[8]Hafron J, Fogarty JD, Boczko D, et al. Combined ureterorenoscopy and shockwave lithotripsy for large renal stone burden:an alternative to percutaneous nephrolithotomy. J Endourol 2005; 19:464-8.
[9]Marguet CG, Springhart WP, Tan YH, et al. Simultaneouscombined use of flexible ureteroscopy and percutaneousnephrolithotomy to reduce the number of access tracts inthe management of complex renal calculi. BJU Int2005;96:1097-100.
[10]Tiselius HG Stone incidence and prevention. Braz J Urol,2000,26(5): 452-462.
[11]Litwin MS, Saigal CS, Yano EM, et al. Urologic diseases in America Project: analytical methods and principal findings. J Urol,2005,173(3):933-937.
[12]孙伟桂,丁智仁,张峻,等.广西地区尿石症患者年龄分布曲线特征及临床意义.中华泌尿外科杂志,2001,22(2)：100-102.
[13]叶章群,邓耀良,董诚主编.泌尿系结石[M].北京：人民卫生出版社,2003.
[14]那彦群.中国泌尿外科疾病诊断治疗指南.北京：人民卫生出版社,2007：175-8.
[15]Preminger GM, Assimos DG, Lingeman JE, el al. Chapter1:AUA guideline on m anagem ent of staghorn calculi:diagnosis and treatment recommendations. J Urol,2005,173:1991-2000.
[16]Tiselius HG, Ackermann D, Alken P, et al. Guidelines on Urolithiasis[J]. In: EAU guidelines. EAU,2006,5-6.
[17]Rupel E, Brown R. Nephroscopy with removal of stone following nephrostomy for obstructive calculous anuria. J Urol.1941,46:177-9.
[18]Goodwin WE, Casey WC, Woolf W. Percutaneous trocar (needle) nephrostomy in hydronephrosis. JAMA.1955,157:891-4.
[19]Fernstrom I, Johansson B. Percutaneous pyelolithotomy. A new extractiontechnique. Scand J Urol Nephrol.1976,10:257-9.
[20]Wickham JE, Kellett MJ. Percutaneous nephrolithotomy. Br J Urol.1981, 53:297-9.
[21]Smith AD, Reinke DB, Miller RP, et al. Percutaneous nephrostomy in the management of ureteral and renal calculi. Radiology,1979,133:49-54.
[22]Gunther R, AlkenP.Percutaneous Nephrostomy in Obstructive Uropathy. Radiology Today,1983,2:94-100.
[23]Alken P, Hutschenreiter G, Gunther R, et al. Percutaneous stone manipulation. J Urol.1981,125:463-6.
[24]Segura JW, Patterson DE, LeRoy AJ, et al. Percutaneous removal of kidney stones:preliminary report. Mayo Clin Proc. 987,57:615-9.
[25]Marberger M, Steckl W, Hruby W. Percutaneous litho-lapaxy of renal calculi with ultrasound. Eur Urol.1982,8:236-42.
[26]叶章群.中国泌尿外科疾病诊断治疗指南／尿石症诊治指南.北京：人民卫生出版社,2010.
[27]Stoller ML, Wolf JS, St Lezin MA. Estimated blood loss and transfusionrates associated with percutaneous nephrolithotomy. J Urol1994;152:1977.
[28]Martin X, Tajra LC, Aboutaieb R, et al. Complete staghorn stones:Percutaneous approach using one or multiple percutaneous accesses.J Endourol 1999; 13:367.
[29]Streem SB. Long-term incidence and risk factors for recurrent stonesfollowing percutaneous nephrostolithotomy or percutaneous nephrostolithotomy/ extracorporeal shock wave lithotripsy for infection relatedcalculi. J Urol 1995;153:584-7.
[30]Tiselius HG, Ackermann D, Alken P, Buck C, Conort P, Gallucci M.Working Party on Lithiasis. European Association of Urology. EurUrol 2001;40(4):362-71.
[31]Albala DM, Assimos DG, Clayman RV, Denstedt JD, Grasso M,Gutierrez-Aceves J, et al. A prospective randomized trial of extracorporealshock wave lithotripsy and percutaneous nephrostolithotomy forlower pole nephrolithiasis: initial results. J Urol 2001; 166:2072-80.
[32]Fuchs GJ, Yurkanin JP. Endoscopic surgery for renal calculi. Cur OpinUrol 2003; 13:243-7.
[33]Hollenbeck BK, Schuster TG, Faerber GJ, Wolf JS. Flexible ureteroscopyin conjunction with in situ lithotripsy for lower pole calculi.Urology 2001;58(6):859-63.
[34]Canales B, Mogna M. Surgical management of the calyceal diverticulum.Curr Opin Urol 2003;13(3):255-60.
[35]Monga M, Smith R, Ferral H, et al. Percutaneous ablation of calicealdiverticulum:long-term followup. J Urol 2000; 163:28-32.
[36]Callaway TW, Lingardh G, Basata S, et al. Percutaneousnephrolithotomyin children. J Urol 1992; 148(3 pt 2):1067-8.
[37]Mor Y, Elmasry YE, Kellett MJ, et al.The role of percutaneousnephrolithotomy in the management of pediatric renal calculi. J Urol1997; 158(3 pt 2):1319-21.
[38]Fraser M, Joyce AD, Thomas DF, et al. Minimallyinvasive treatment of urinary tract calculi in children. BJU Int 1999;84(3):339-42.
[39]Jackman SV, Hedican SP, Peters CA, et al. Percutaneousnephrolithotomy in infants and preschool age children:experiencewith a new technique. Urology 1998;52(4):697-701.
[40]Dawaba MS, Shokeir AA, Hafez AT, et al.Percutaneous nephrolithotomy in children:early andlate anatomical and functional results. J Urol 2004;172(3):1078-1081.
[41]Riedmiller H, Androulakakis P, Beurton D, et al.EAU guidelines on paediatric urology. Eur Urol 2001;40(5):589-99.
[42]Desai M. Endoscopic management of stones in children.Curr Opin Urol 2005;15:107-112.
[43]Woodside JR, Stevens GF, Stark GL, et al. Percutaneousstone removal in children. J Urol 1985;134(6):1166-7.
[44]Raj GV, Auge BK,Weizer AZ, et al. Percutaneous management of calculi within horseshoe kidneys. JUrol 2003;170(1):48-51.
[45]Kupeli B, Isen K, Biri H, et al.Extracorporeal shock wave lithotripsy in anomalous kidneys. JEndourol 1999;13(5):349-52.
[46]Lu HF, Shekarriz B, Stoller ML. Donor-gifted allograft urolithiasis:early percutaneous management. Urology 2002;59(1):25-7.
[47]Ramakumar S, Segura JW. Renal calculi:percutaneous management.Urol Clin North Am 2000;27(4):617-22.
[48]Pearle MS, Nakada SY, Womack JS, et al. Outcomes of contemporarypercutaneous nephrostolithotomy in morbidly obesepatients. J Urol 1998;160(3 pt 1):669-73.
[49]Koo BC, Burtt G, Burgess NA. Percutaneous stone surgery in theobese: outcome stratified according to body mass index. BJU Int 2004;93(9):1296-9.
[50]El-Assmy AM. Outcome of Percutaneous Nephrolithotomy:Effect of Body Mass Index,Eur Urol (2006), doi:10.1016
[51]Netto Junior N, Lemos GC, Fiuza JL. Percutaneous nephrolithotomyin patients with previous renal surgery. Eur Urol 1988;14(5):353-5.
[52]Basiri A, Karrami H, Moghaddam SM, et al. Percutaneousnephrolithotomy in patients with or without a history of open nephrolithotomy.J Endourol 2003; 17(4):213-6.
[53]Helal M, Black T, Lockhart J, et al. The Hickman peel-away sheath:alternative for pediatric percutaneous nephrolithotomy. J Endourol.1997,11:171-2.
[54]Jackman SV, Docimo SG, Cadeddu JA, et al. The'mini-perc' technique:a less invasive alternative to percutaneous nephrolithotomy. World J Urol.1998,16:371-4.
[55]Monga M, Oglevie S. Minipercutaneous nephrolithotomy. J Endourol.2000, 14:419-21.
[56]Lahme S, Bichler KH, Strohmaier WL, et al. Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol.2001,40:619-24.
[57]郭应禄,潘柏年,薛兆英,等.经皮肾镜穿刺取石术.中华外科杂志,1986,24：34-5.
[58]余安迪,王邦宏,吴腾斐,等.经皮穿刺肾石取出术42例初步报告.中华泌 尿外科杂志,1986,7：67-9.
[59]杨运彰,吴开俊,袁坚,等.经皮穿刺肾造痰取石术.中华医学杂志,1986,66：279-81.
[60]吴开俊,李逊,袁坚,等.经皮肾微造瘘术后二期经皮输尿管镜取石术治疗鹿角形结石.广州医学院学报,1993,21：13-5.
[61]李逊,曾国华,袁坚,等.经皮肾穿刺取石术治疗上尿路结石(20年经验).北京大学学报(医学版),2004,36：124-6.
[62]Sung YM, Choo SW, Jeon SS, et al. The "mini-perc" technique of percutaneous nephrolithotomy with a 14-Fr peel-away sheath:3-year results in 72 patients.Korean J Radiol.2006,7(1):50-6.
[63]Nagele U, Schilling D, Anastasiadis AG, et al. Minimally invasive percutaneous nephrolitholapaxy (MIP). Urologe A.2008,47(9):1066,1068-73.
[64]Lahme S, Zimmermanns V, Hochmuth A, et al. Minimally invasive PCNL (mini-perc). Alternative treatment modality or replacement of conventional PCNL?.Urologe A.2008,47(5):563-8.
[65]Wah TM, Kidger L, Kennish S, et al. MINI PCNL in a pediatric population. Cardiovasc Intervent Radiol.2013;36(1):249-54.
[66]Zhong W, Zeng G, Wu W, et al.Minimally invasive percutaneous nephrolithotomy with multiple mini tracts in a single session in treating staghorn calculi. Urol Res.2011;39(2):117-22.
[67]李逊,徐桂彬,何永忠,等.微创经皮肾取石术治疗孤立肾铸型结石的疗效观察.临床泌尿外科杂志,2009,24：653-5.
[68]Maurice SM, Lutz T, Jens JR. Complications in Percutaneous Nephrolithotomy. Eur Urol,2006,10.1016.
[69]Valdivia Uria JG, Valle Gerhold J, Lopez Lopez JA, et al. Techniqueand complications of percutaneous nephroscopy:experience with 557patients in the supine position. J Urol 1998;160(6 Pt 1):1975-8.
[70]Desai M, Ridhorkar V, Patel S, et al. Pediatricpercutaneous nephrolithotomy: assessing impact of technical innovations on safety and efficacy. J Endourol 1999; 13:359-64.
[71]Ng MT, Sun WH, Cheng CW, et al. Supine positionis safe and effective for percutaneous nephrolithotomy.J Endourol 2004; 18:469-74
[72]Shoma AM, Eraky I, El-Kenawy MR, et al. Percutaneousnephrolithotomy in the supine position:technical aspects and functionaloutcome compared with the prone technique. Urology 2002;60:388-92.
[73]Matlaga BR, Shah OD, Zgoria RJ, et al.Computerized tomography guided access for percutaneous nephrolithotomyJ Urol 2003; 170:45-7.
[74]Munver R, Delvechio F, Newman G, et al. Critical analyses ofsupracostal access for percutaneous renal surgery. J Urol 2001;166:1242-6.
[75]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study.J Endourol.2004 Oct;18(8):715-22.
[76]Munver R, Delvechio F, Newman G, et al. Critical analyses ofsupracostal access for percutaneous renal surgery. J Urol 2001;166:1242-6.
[77]Kukreja R, Desai M, Patel S, et al. Factors affecting blood loss during percutaneous nephrolithotomy:prospective study.J Endourol.2004 Oct;18(8):715-22.
[78]Kim SC, Kuo RL, Lingeman JE. Percutaneous nephrolithotomy:anupdate. Curr Opin Urol 2003;13:235-41.
[79]Allen P, Hutschenreiter G, Gunther R, et al. Percutaneousstone manipulation. J Urol 1981;125:463-7.
[80]Segura JW, Patterson DE, Leroy AJ, et al. Percutaneouslithotripsy. J Urol 1983;130:1051-4.
[81]Clayman RV, Castaneda-Zuniga WR, Hunter J, et al. Rapid balloon dilatation of the nephrostomy track fornephrostolithotomy. Radiology 1983;147:884-5.
[82]Davidoff R, Bellman G Influence of technique of percutaneous tractcreation on incidence of renal hemorrhage. J Urol 1997; 157:1229-31.
[83]Safak M, Gogus C, Soygur T. Nephrostomy tract dilation using aballoon dilator in percutaneous renal surgery:experience with 95 casesand comparison with the fascial dilator system. Urol Int 2003;71(4):382-4.
[84]Bellman GC, Davidoff R. Influence of technique of percutaneoustract creation on incidence of renal hemorrhage. J Urol1997;157:1229.
[85]徐桂彬,李逊,何永忠,等.微创肾镜与输尿管镜在微创经皮肾穿刺取石术治疗上尿路结石中的对比研究.临床泌尿外科杂志.2011,3：172-173.
[86]徐桂彬,李逊,何永忠,等.微创经皮肾镜取石术联合负压装置一期治疗结石性脓肾的疗效分析.中华泌尿外科杂志,2013,34：93-95.
[87]Desai MR, Sharma R, Mishra S, et al. Single-step percutaneous nephrolithotomy (microperc):the initial clinical report.J Urol. 2011;186(1):140-5.
[88]Landman J, Venkatesh R, Lee DI, Rehman J, et al. Combined percutaneous and retrograde approach to staghorn calculi with application of the ureteral access sheath to facilitate percutaneous nephrolithotomy. J Urol,2003,169(l):64-67.
[89]Marguet CG, Springhart WP, Tan YH, et al. Simultaneous combined use of flexible ureteroscopy and percutaneous nephrolithotomy to reduce the number of access tracts in the management of complex renal calculi. Bju Int,2005, 96(7):1097-1100.
[90]Guibin Xu, Xun Li, Yongzhong He, et al. Staged single-tract minimally invasive percutaneous nephrolithotomy and flexible ureteroscopy in the treatment of staghorn stone in patients with solitary kidney. Urological Research.2012,40(6):745-749.
[91]李逊,徐桂彬,何永忠,等.单通道经皮肾镜取石术联合逆行输尿管软镜治疗复杂性肾结石疗效观察(附79例报告).临床泌尿外科杂志.2012,27(6)：452-454.
[92]Lawson RK, Murphy JB, Taylor AJ, et al. Retrograde method for percutaneous access to kidney. Urology,1983,22:580-582.
[93]Hunter PT, Finlayson B, Drylie DM, et al. Retrograde nephrostomy and percutaneous calculus removal in 30 patients. J Urol,1985,133:369-374.
[94]Kawahara T, Matsuzaki J, Kubota Y. Ureteroscopy-assisted retrograde nephrostomy for an obese patient. Indian J Urol.2012 Oct;28(4):439-41.
[95]Takashi Kawahara, Hiroki Ito, Hideyuki Terao, et al. Effectiveness of Ureteroscopy-Assisted Retrograde Nephrostomy (UARN) for Percutaneous Nephrolithotomy (PCNL). PLoS One.2012; 7(12):e52149.
[96]Lee WJ, Smith AD, Cubelli V, Badlani GH., et al. Complications of percutaneous nephrolithotomy. AJR,148:177,1987.
[97]RothRA, Beckmann CF.Complications of extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy. Urol. Clin. N. Amer.,15:155,1988.
[98]CarsonCC. Complications of percutaneous stone extraction:prevention and treatment. Sem. Urol.,4:161,1986.
[99]Clayman RV, Hunter D, Surya V, ea al.Percutaneous intrarenal electrosurgery. J. Urol,131:864,1984.
[100]Gavant ML, Gold RE, Church JC. Delayed rupture of renal pseudoaneurysm: complication of percutaneous nephrostomy. AJR,138:948,1982.
[101]Cope C, Zeit RM. Pseudoaneurysms after nephrostomy. AJR,139:255,1982.
[102]Segura JW, Preminger GM, Assimos DG, et al. NephrolithiasisClinical Guidelines Panel Summary Report on the Management ofStaghorn Calculi. J Urol 1994;151:1648.
[103]Rodrigues Netto, N Jr. Lemos, G C. Palma, P C. Fiuza, J L. Staghorn calculi: percutaneous versus anatrophic nephrolithotomy. European Urology. 15(1-2):9-12,1988.
[104]Kessaris DN, Bellman GC, Pardalidis NP, Smith AD. Managementof hemorrhage after percutaneous renal surgery. J Urol 1995;153:604.
[105]Stoller ML, Wolf JS, St Lezin MA. Estimated blood loss and transfusionrates associated with percutaneous nephrolithotomy. J Urol 1994; 152:1977.
[106][83].Kahnoski RJ, Lingeman JE, Coury TA, Steele RE, Mosbaugh PG.Combined percutaneous and extracorporeal shock wave lithotripsyfor staghorn calculi:An alternative to anatrophic nephrolithotomy.J Urol 1986;135:679.
[107]Snyder JA, Smith AD. Staghorn calculi:Percutaneous extractionversus anatrophic nephrolithotomy. J Urol 1986; 131:351.
[108]Puttipannee V, Krisana P, Em-Orn R, et al. Perioperative complications and risk factors of percutaneous nephrolithotomy. J Med Assoc Thai 89(6),2006.
[109]DoganHS, SahinA,CetinkayaY,AkdoganB,OzdenE,KendiS. Antibiotic prophylaxis in percutaneous nephrolithotomy:prospective study in 81 patients. J Endourol2002; 16:649-53.
[110]Aron M, Yadav R, Goel R, et al. Multi-tract percutaneousnephrolithotomy for large complete staghorn calculi. UrolInt 2005;75:327-32.
[111]Vorrakitpokatorn P, Permtongchuchai K, Raksamani EO,Phettongkam A. Perioperative complications and risk factorsof percutaneous nephrolithotomy. J Med Assoc Thai2006;89:826-33.
[112]Ichel MS, et al.Complications in Percutaneous Nephrolithotomy, Eur Urol (2006),10-020.
[113]Shaw, G. Wah, T M. Kellett, M J. Choong, S K S. Management of renal-vein perforation during a challenging percutaneous nephrolithotomy. Journal of Endourology.19(6):722-3,2005 Jul-Aug.
[114]Pardalidis NP, Smith AD. Complications of percutaneous renal procedures.In: Controversies in Endourology. Philadelphia:WB Saunders,1995, p 179.
[115]Liatsikos EN, Kapoor R, Lee B, Jabbour M, Barbalias G,Smith AD. "ngular percutaneous renal access".Multiple tracts through a single incision for staghorncalculous treatment in a single session. Eur Urol2005;48:832-7.
[116]Gupta R, Kumar A, Kapoor R, Srivastava A, Mandhani A.Prospective evaluation of safety and efficacy of thesupracostal approach for percutaneous nephrolithotomy.BJU Int 2002;90:809-13.
[117]E1-Nahas AR, Shokeir AA, El-Assmy AM, et al. Colonicperforation during percutaneous nephrolithotomy:studyof risk factors. Urology 2006;67:937-41.
[118]Gerspach JM, Bellman GC, Stoller ML, Fugelso P. Conservativemanagement of colon injury following percutaneousrenal surgery. Urology 1997;49:831-6.
[119]Vallancien G, Capdeville R, Veillon B, Charton M, BrissetJM. Colonic perforation during percutaneous nephrolithotomy.J Urol 1985; 134:1185-7.
[120]Takeuchi H, Ueda M, Nonomura M, et al. Fever attack inpercutaneous nephrolithotomy and transurethral ureterolithotripsy.Hinyokika Kiyo 1987;33:1357-63.
[121]李逊.经皮肾镜取石术的微创理念.中华腔镜泌尿外科杂志(电子版).2010,4(3)：176-179.