Saussine C, Lechevallier E, Traxer O
Service d'urologie, hôpital Civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
Prog Urol. 2008 Dec;18(12):901-7. doi: 10.1016/j.purol.2008.09.045. Epub 2008 Oct 22.
Tubeless PCNL has been promoted by Bellman in 1997 and consists in a PCNL without placing a nephrostomy tube at the end of the procedure. Double J stent or ureteral stent are the most common internal drainage used but totally tubeless PCNL has been described by using no ureteral stent. Tubeless PCNL is safe and efficient. Exclusion criteria to propose a tubeless procedure are significant bleeding or purulent renal discharge. Stone size or location, shape, position or function of the kidneys are also irrelevant with regard to tubeless PCNL. A nephrostomy tube should be placed if a second look is necessary. Some hemostatic agents have been described but none has really proved its efficacy. The results of the more recent series of the literature will be presented.
无管经皮肾镜取石术(PCNL)由贝尔曼于1997年提出,是指在手术结束时不放置肾造瘘管的经皮肾镜取石术。双J管或输尿管支架是最常用的内引流方式,但也有不使用输尿管支架的完全无管PCNL的报道。无管PCNL安全且有效。提出无管手术的排除标准是严重出血或肾脓性分泌物。结石大小、位置、形状、肾脏的位置或功能与无管PCNL也无关。如果需要再次探查,则应放置肾造瘘管。已经描述了一些止血剂,但没有一种真正证明其有效性。将展示文献中最新系列的结果。