中文摘要：

目的：探讨超微经皮肾镜取石术（Micro—percutaneous nephrolithotomy，micro-PCNI。）治疗肾结石的可行性及安全性。方法：回顾性分析2012年4～5月行micro—PCNI。术的2例患者临床资料：2例患者均为下盏结石，大小分别为1．2cm和1．6crn，均有ESWI。及输尿管软镜治疗失败史。采用F4.85。可视穿刺针（all—seeing needle）在x线引导下从下盏入路穿中目标盏，并直视下结合钬激光进行碎石。结果：2例患者穿刺均由下盏人路，手术时间分别为45min和55min，术后均未留置造瘘管。术后无感染、发热及出血、疼痛、尿液外渗，无输尿管石街形成等并发症。术后分别于24h、48h出院。术后4周CT复查，2例患者均无结石残留。结论：micro—PCNI。治疗2cm以下肾结石安全有效，尤其可作为ESWL及输尿管软镜治疗失败后的一种补救性治疗方法。

英文摘要：

Objective： To report the first technical feasibility and safety study of micro-percutaneous nephrolithotomy（Micro-PCNL） in china. Methods： Micro-PCNL was done using the F4. s~ all-seeing needle to achieve collecting system access under direct vision and C-arm fluoroscopic guidance in the prone positions and using holmium： YAG laser fiber to disintegrate the stones. We reviewed the date of our 2 patients who was performed micro- PCNI.. The stones were located lower calyces. The stone size were 1.2 cm and 1.6 cm respectively. They all had a failure treatment of history by ESWL（extraeorporeal shock wave lithotripsy） and RIRS（retrograde intrarenal surgery）. Results： The access was performed through the lower calyces. The operative time was 45 rain and 55 rain. No nephrostomy tube was left after the procedures. No complications was occurred such as fever, infection, bleeding, pain, extravasation and steinstrasse. They were discharged hospital postoperative day 1 and day 2, respectively. The stones were free completely after 4 weeks on CT scan. Conclusions： Micro-PCNL is technically feasible, safe and efficacious for kidney stones less than 2cm, especially as a salvaged treatment modality after the failure treatment of ESWL or RIRS.