Moroni F, Dedola G, Melone F, Lardani T, Menchi I
Servizio di Radio-Urologia Villa Monna Tessa, Policlinico di Careggi, Firenze.
Radiol Med. 1992 Apr;83(4):439-44.
The authors report on 80 cases of ureteral calculi treated with in situ extracorporeal shock wave (ESWL), with no retrograde or antegrade maneuvers. Success rate was high (97.5%). Forty-two calculi were located in the proximal ureter above the sacroiliac joint; 10 were in the pre-sacral ureter, and 28 in the pelvic ureter, below the inferior border of the sacroiliac joint. After ESWL, double-J stents were positioned in 5 patients and nephrostomy was performed in 4 cases with positioning of 7-F pig-tail catheters; 8 patients (10%) underwent additional post-lithotripsy urologic and radiologic examinations. Lithotripsy having failed in 2 patients (2.5%), surgery with ureterolithotomy was performed. In situ ESWL of ureteral calculi emerges from this trial as the treatment of choice and not as an alternative to urologic maneuvers or open surgery with ureterolithotomy: the latter methods are necessary only after ESWL failure.
作者报告了80例原位体外冲击波（ESWL）治疗输尿管结石的病例，未进行逆行或顺行操作。成功率很高（97.5%）。42枚结石位于骶髂关节上方的输尿管近端；10枚位于骶前输尿管，28枚位于骶髂关节下缘以下的盆腔输尿管。ESWL后，5例患者放置了双J支架，4例进行了肾造瘘并放置了7F猪尾导管；8例患者（10%）在碎石术后接受了额外的泌尿外科和放射学检查。2例患者（2.5%）碎石失败，进行了输尿管切开取石手术。输尿管结石原位ESWL在本试验中成为首选治疗方法，而非泌尿外科操作或输尿管切开取石开放手术的替代方法：只有在ESWL失败后才需要后两种方法。
