Résumé
ABSTRACT Purpose To compare the efficacy of percutaneous nephrolithotomy (PCNL) as a primary procedure of patients following previous open surgery or post percutaneous nephrolithotomy (PCNL) for renal calculi. Materials and Methods The medical records of 367 patients who underwent PCNL by a single surgeon from January 2008 to December 2013 were reviewed retrospectively. All patients were divided into 3 Groups. Group-1 (n=232) included patients with no history of ipsilateral open stone surgery. Group 2 (n=86) patients had undergone one or more open stone surgeries before PCNL, patients with failed or recurrence following PCNL were placed in Group-3 (n=49). The demographic data, operation duration, stone free rate (SFR), number of attempts to access the collecting system and intra operative and postoperative complications between the three Groups were compared. Results There was no difference in sex, Body Mass Index (BMI), stone burden and laterality among the three Groups. Operation time was significantly less in first Group, while there was a statistically significant difference in operation duration between second and third Groups (p<0.05). The number of attempts to enter the collecting system was lower in the first Group in comparison to other two Groups (p<0.5). There was no significant differences among three groups in stone free rate. Intra operative and postoperative complications were slightly more frequent in Groups 2 and 3. Mortality occurred in 1 patient with colon perforation in Group-2. Conclusion Our study demonstrated that PCNL can be performed in patients even as secondary procedure without further complications.
Sujets)
Humains , Mâle , Femelle , Adulte , Jeune adulte , Néphrostomie percutanée/effets indésirables , Néphrostomie percutanée/méthodes , Calculs rénaux/chirurgie , Complications postopératoires , Facteurs temps , Facteurs sexuels , Dossiers médicaux , Études rétrospectives , Facteurs de risque , Analyse de variance , Résultat thérapeutique , Survie sans rechute , Durée opératoire , Adulte d'âge moyenRésumé
We report a 45-year-old man and a 60-year-old woman who presented with features of intermittent intestinal obstruction. Barium enema revealed narrowing at the pelvic-rectal junction in the man, and from the pelvic colon to the anal verge in the woman. Histology of the resected sections showed marked hypertrophy of the muscularis propria in both cases, with normal mucosa, submucosa and myenteric plexus. Both patients are asymptomatic at 4 years' and 2 years' follow up. This entity of primary hypertrophic colonopathy may be a variant of primary visceral myopathy.