Abrahams Harrison M, Stoller Marshall L
Department of Urology, University of California-San Francisco, 400 Parnassus Avenue, Box 0738, San Francisco, CA 94143, USA.
Urol Clin North Am. 2004 Feb;31(1):83-7. doi: 10.1016/S0094-0143(03)00085-5.
The current authors' experience with thousands of ureteroscopic procedures has led them to believe that ureteral access sheaths are seldom necessary. No study to date has accurately determined an advantage of using these sheaths for routine ureteroscopy. The current authors have outlined their alternative methods that eliminate the reported advantages of the sheaths. Their philosophy of stone treatment uses laser lithotripsy for small stone burdens and SWL or PNL for larger stone burdens and eliminates the need for prolonged ureteroscopic procedures. Several disadvantages of access sheaths are evident. When this information is taken into account, the routine use of a ureteral access sheath becomes unnecessary. It is only in unusual cases that ureteral access sheaths are of any utility.
目前作者在数千例输尿管镜手术中的经验使他们认为输尿管通路鞘很少有必要。迄今为止，尚无研究能准确确定在常规输尿管镜检查中使用这些鞘的优势。目前的作者已经概述了他们的替代方法，这些方法消除了报道中鞘的优势。他们的结石治疗理念是，对于较小的结石负荷采用激光碎石术，对于较大的结石负荷采用体外冲击波碎石术（SWL）或经皮肾镜取石术（PNL），从而避免了长时间输尿管镜手术的需要。输尿管通路鞘的几个缺点很明显。考虑到这些信息，常规使用输尿管通路鞘就变得没有必要了。只有在特殊情况下，输尿管通路鞘才有用处。
