Borrell Palanca A, Ferrer Puchol M D, Villamón Fort R, Gil Romero J
Servicio de Urología, Hospital Clínico Universitario, Valencia.
Actas Urol Esp. 2000 Mar;24(3):243-7. doi: 10.1016/s0210-4806(00)72439-9.
We report twenty-four patients with urinary obstruction, in which twenty-seven antegrade ureteral stent (double J) insertions were attempted (in six patients the obstruction was bilateral and in three other patients we failed). In all of them access to the urinary tract was through a nephrostomy catheter, in seventeen cases we proceeded to insert the antegrade catheter immediately after percutaneous nephrostomy and in ten remaining cases we achieved in a second try after carrying nephrostomy and failing a conventional retrograde approach to ureteral stent insertion. We got a 90-per cent success rate. A case of perirrenal hematoma occurred after applying a nephrostomy. It was the only relevant complication. In conclusion we consider that the antegrade ureteral stent insertion is a good alternative when, under several circumstances, the conventional retrograde insertion fails.
我们报告了24例尿路梗阻患者,共尝试进行了27次顺行输尿管支架(双J管)置入术(6例患者为双侧梗阻,另有3例失败)。所有患者均通过肾造瘘导管进入尿路,17例在经皮肾造瘘后立即插入顺行导管,其余10例在进行肾造瘘且传统逆行输尿管支架置入失败后再次尝试成功。成功率为90%。1例患者在进行肾造瘘后出现肾周血肿,这是唯一的相关并发症。总之,我们认为在多种情况下传统逆行置入失败时,顺行输尿管支架置入是一种很好的替代方法。