Knoll T, Trojan L, Haecker A, Michel M S, Köhrmann K U, Alken P
Urologische Klinik, Universitätsklinikum Mannheim.
Aktuelle Urol. 2003 Sep;34(5):313-8. doi: 10.1055/s-2003-42005.
Open surgery was the standard therapy for urinary calculi up to about 30 years ago. This changed upon introduction of extracorporeal shockwave lithotripsy (ESWL) in 1980, a procedure that is now the primary therapy for 70 % of the patients in western countries. Simultaneously, endourological procedures like ureterorenoscopy (URS) and percutaneous nephrolithotripsy (PCNL) have been improved, and now, modern small diameter and highly efficient instruments offer an ideal alternative to shockwave lithotripsy. Today, minimally-invasive stone treatment has replaced open stone surgery almost completely. This article introduces ESWL, URS and PCNL and discusses indications, outcomes and limitations.
直到大约30年前,开放手术一直是治疗尿路结石的标准疗法。1980年体外冲击波碎石术(ESWL)的引入改变了这一状况,如今该手术是西方国家70%患者的主要治疗方法。同时,输尿管肾镜检查(URS)和经皮肾镜碎石术(PCNL)等腔内泌尿外科手术也得到了改进,现在,现代小直径且高效的器械为冲击波碎石术提供了理想的替代方案。如今,微创结石治疗几乎完全取代了开放结石手术。本文介绍了ESWL、URS和PCNL,并讨论了其适应症、治疗效果和局限性。