Gross Andreas J, Fisher Megan
Abteilung für Urologie, AK Barmbek, Hamburg, Germany.
Curr Opin Urol. 2006 Mar;16(2):100-5. doi: 10.1097/01.mou.0000193380.16480.e1.
Congenital abnormities in urology are very common. Horseshoe, malrotated and ectopic kidneys, as well as duplex systems, are the most frequent in this respect. The combination of both abnormalities and stones is of clinical importance. The question is asked if standard procedures for stones apply also to stones in abnormal kidneys.
In general, open surgery, extracorporeal shock-wave lithotripsy, percutaneous procedures, endoscopic procedures and laparoscopy are possible procedures in both normal and abnormal kidneys. The importance of ureteric pelvic junction obstruction has to be taken into account and a metabolic work-up remains important.
The trend for treatment of stones in abnormal kidneys goes towards endoscopical and laparoscopical procedures, whereas a combination of both seems to be appropriate in many cases.
泌尿外科先天性异常非常常见。马蹄肾、旋转不良肾、异位肾以及重复肾系统在这方面最为常见。异常与结石并存具有临床重要性。问题在于治疗结石的标准程序是否也适用于异常肾脏中的结石。
一般而言，开放手术、体外冲击波碎石术、经皮手术、内镜手术和腹腔镜手术在正常和异常肾脏中都是可行的手术方式。必须考虑输尿管肾盂连接处梗阻的重要性，代谢检查仍然很重要。
治疗异常肾脏结石的趋势是采用内镜和腹腔镜手术，而在许多情况下两者结合似乎是合适的。
