Nagele U, Knoll T, Schilling D, Michel M S, Stenzl A
Klinik für Urologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Deutschland.
Urologe A. 2008 Jul;47(7):875-84. doi: 10.1007/s00120-008-1780-8.
Due to its particular anatomical position below the ureteropelvic junction, the lower pole group of calices plays a special role in the treatment of nephrolithiasis. The extracorporeal shock-wave lithotripsy (ESWL) often attains dissatisfactory stone-free rates, even after optimal disintegration of lower pole stones, and thus necessitates secondary therapeutic procedures. Due to the favorable stone-free rates, retrograde intrarenal surgery with its low complication rate has taken up an important role in the treatment of lower pole stones since the development of modern flexible ureterorenoscopes. The long treatment times in the case of a large stone burden and considerable costs for materials constitute limiting factors. In line with the advancement of percutaneous nephrolitholapaxy (PCNL), a promising method also for the treatment of larger lower pole stones is available today with minimally invasive PCNL (MIP).
由于其在肾盂输尿管连接处下方的特殊解剖位置，下极肾盏组在肾结石治疗中发挥着特殊作用。即使在下极结石最佳粉碎后，体外冲击波碎石术（ESWL）的结石清除率往往也不尽人意，因此需要二次治疗程序。由于结石清除率良好，自现代软性输尿管肾镜问世以来，逆行肾内手术及其低并发症率在治疗下极结石方面发挥了重要作用。结石负荷大时治疗时间长以及材料成本高构成了限制因素。随着经皮肾镜取石术（PCNL）的发展，如今一种有前景的治疗较大下极结石的方法是微创经皮肾镜取石术（MIP）。
