【摘要】 目的 为了既能保留功能良好的患有鹿角型结石的患肾，又能取净肾盂内结石和减轻创伤，探讨用手助腹腔镜取肾、离体肾切开取石、自体肾移植治疗肾盂鹿角型结石的手术方法和临床效果。方法 术前行静脉尿路造影和数字减影血管造影检查，以了解肾血管及髂血管情况。手术全麻下进行，先行脐部切开插入Trocar固定后，CO2人工气腹，手助切口不单设切口，借助肾移植切口采用蓝碟技术。肾脏由此口取出灌洗后髂窝处行自体肾移植手术。结果 手术历时7.5h，失血400ml，术中放射线肾片证实患肾内结石彻底取净，移植肾热缺血时间7min，血管吻合完毕开放后1min内泌尿，移植肾功能良好。结论 采用手助腹腔镜代替传统开放手术取肾与自体肾移植结合治疗肾盂鹿角型结石，手术创伤小，痛苦小，恢复快，能彻底取净结石，为治疗肾功能良好的肾盂多发、复杂的鹿角型结石提供良好的微创手术方法，值得推广。

    【关键词】 腹腔镜；鹿角型结石；自体肾移植

    【Abstract】 Objective In order to reserve the nomally funictioning kidney with complex staghorn renal stone, remove the stone clearly and decrease the trauma, to evaluate the operation technique and clinical efficacy of hand-assisted laparoscopic nephrectomy,isolated pyelolithotomy autotransplantation of kidncy cure staghorn renal stone. Methods By intravenous urography anel the digital subtraction angiography, the conditions of ilium blood vessels and kidney blood vessels can be known. The operation is undergone below the general anesthesia. The umbilicus incision in trocar to fix it,CO2 pneumoperitoneum. Hanby-assisted incision is the kidney removal incision.Results Operation time is 7.5 hours with warm ischemia time being 7min and the blood vessels coincide to complete to be open secrete urine inner 1min. The grafting kidney is growed.Conclusion Hand-assisted laparoscopic replale the traditional operation to get kidney together with autotransplantation of kidney is a better way to deal with complex staghorn renal stone. The operation wound is little. Suffering is little.So the operation should be spreaded widely. ......