复杂性泌尿系结石治疗新方法：针状肾镜辅助内镜手术（“大家泌尿网”观看手术视频）

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New treatment methods for complex urinary stones：Needle-perc assisted endoscopic surgery

LIU Yubao，LI Jianxing

（Department of Urology，Beijing Tsinghua Changgung Hospital，School of Clinical Medicine，Tsinghua University，Beijing 102218，China）

ABSTRACT：Complex urinary stones have been the focus and difficulty of clinical treatment.Traditional multi-channel percutaneous nephrolithotomy （PCNL） has a high stone-free rate and efficacy in the treatment of multiple or large volume kidney stones，but has risk of serious complications such as bleeding and injury.Retrograde intrarenal surgery （RIRS） has been preferred in the treatment of renal stones with a diameter of less than 2 cm due to its characteristics of small trauma and fast recovery.However，it is difficult to treat small calyx stones with poor anatomy，lower renal calyx stones with small IPA，and diverticulum stones.Needle-perc assisted endoscopic surgery （NAES） includes the following modes：①Needle-perc plus PCNL，which can effectively reduce the number of channels，reduce surgical risks，and protect kidney function while ensuring a high stone-free rate; ②Needle-perc plus RIRS，which can significantly improve the success rate and stone-free rate without increasing kidney damage，thus having significant advantages in dealing with complex urinary stones.In order to popularize and promote this technique，this essay will review the relevant domestic and foreign literature and the clinical experience of our center，focusing on the indications，usage specifications，operative skills and precautions of NAES.

KEY WORDS：complex urinary stones; Needle-perc; Needle-perc assisted endoscopic surgery; percutaneous nephrolithotomy; retrograde intrarenal surgery

摘要：复杂性泌尿系结石一直是临床治疗的重点与难点。（剩余8726字）