Nagele Udo, Anastasiadis Aristotelis G, Schilling David Alexander, Sievert Karl Dietrich, Kuczyk Markus A, Stenzl Arnulf
Department of Urology, University of Tübingen, Tübingen, Germany.
J Endourol. 2007 Apr;21(4):393-6. doi: 10.1089/end.2006.0244.
To achieve better hemostasis after mini-percutaneous nephrolitholapaxy (mini-PCNL), we developed a new application device that can be used to close the renal-access tract with gelatin matrix hemostatic sealant (GMHS).
After mini-PCNL was performed on 11 patients, a Double-J ureteral stent was placed antegrade. After retraction of the 18F Amplatz sheath out of the collecting system under vision without irrigation, the urothelium collapsed. The 15F metal applicator with a 10F working channel was then inserted and GMHS injected during further retraction of both the device and the Amplatz sheath. The skin was closed with Steri-strips.
The renal parenchymal tract of the mini-PCNL can be sealed in 15 to 50 seconds. Postoperatively, no urinoma was observed. All patients had an uneventful follow-up.
Closing the track of the mini-PCNL with the new application device and GMHS is a safe, easy, and quick alternative to the common nephrostomy tube.
为了在微创经皮肾镜取石术（mini-PCNL）后实现更好的止血效果，我们研发了一种新的应用装置，该装置可用于用明胶基质止血密封剂（GMHS）封闭肾穿刺通道。
对11例患者进行mini-PCNL后，顺行置入双J输尿管支架。在直视下不冲洗将18F安普瑞兹鞘从集合系统中撤出后，尿路上皮塌陷。然后插入带有10F工作通道的15F金属涂抹器，并在进一步回撤该装置和安普瑞兹鞘的过程中注入GMHS。用无菌胶带封闭皮肤。
mini-PCNL的肾实质通道可在15至50秒内封闭。术后未观察到尿囊肿。所有患者随访过程均顺利。
使用新的应用装置和GMHS封闭mini-PCNL通道是一种安全、简便且快速的替代传统肾造瘘管的方法。
