Lechevallier E, Traxer O, Saussine C
Service d'urologie, hôpital La-Conception, 147, boulevard Baille, 13005 Marseille, France.
Prog Urol. 2008 Dec;18(12):952-4. doi: 10.1016/j.purol.2008.09.013. Epub 2008 Oct 16.
Open surgery for stones of the upper urinary tract has very few indications, failures or complications of other techniques, greater than 2cm stones, hard stones, anatomical abnormalities and complex stones. Open surgery for stone may be difficult and need specific tools. For the kidney, the anatrophic nephrotomy is an effective procedure which spares the renal function. For the ureter, the mini-ureterotomy is no more invasive than laparoscopy. The stone-free rate of open surgery is over 90%. The main complications are stenosis, fistula and infections.
上尿路结石的开放手术适应症极少,适用于其他技术失败或出现并发症的情况、直径大于2厘米的结石、坚硬结石、解剖结构异常以及复杂结石。结石开放手术可能难度较大,需要特定工具。对于肾脏,无萎缩性肾切开取石术是一种有效的手术方式,可保留肾功能。对于输尿管,小型输尿管切开术的侵入性并不比腹腔镜检查高。开放手术的结石清除率超过90%。主要并发症包括狭窄、瘘管和感染。