Chong W L, Murali S, Sahabudin R M, Khairullah A
Institute of Urology, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur.
Med J Malaysia. 2002 Mar;57(1):108-10.
Pros and cons of Percutaneous Nephrolithotripsy (PCNL) versus Extracorporeal Shockwave Lithotripsy (ESWL) have often been highlighted when one discusses on the management of renal stones. An oft quoted point is that PCNL entails a prolonged hospital stay whereas ESWL sessions are day surgical in nature. However, PCNL has superior stone clearance rate as compared to ESWL especially for lower pole stones. In addition, PCNL is more suitable for large bulk stones and when ancillary procedures are required e.g. endopyelotomy. The first 50 cases of successful tubeless PCNL were reported by Bellman et al in 1997. The remarkable recovery of patients in their series encouraged them to employ this technique as their technique of choice for the majority of their cases. A similar technique was employed on endopyelotomy by Liang et al and they concluded that this was a safe, less morbid and effective technique. We report our first case of tubeless PCNL.
在讨论肾结石的治疗方法时，经皮肾镜取石术（PCNL）与体外冲击波碎石术（ESWL）的优缺点常常被重点提及。一个经常被引用的观点是，PCNL需要较长的住院时间，而ESWL本质上属于日间手术。然而，与ESWL相比，PCNL具有更高的结石清除率，尤其是对于下极结石。此外，PCNL更适合处理大块结石以及需要辅助操作（如肾盂内切开术）的情况。1997年，Bellman等人报道了首批50例无管PCNL成功病例。他们系列研究中患者的显著恢复情况促使他们将该技术作为大多数病例的首选技术。Liang等人在肾盂内切开术中采用了类似技术，并得出结论，这是一种安全、并发症少且有效的技术。我们报告了首例无管PCNL病例。
