Lechevallier E, Saussine C, Traxer O
Service d'urologie, hôpital La-Conception, 147, boulevard Baille, 13005 Marseille, France.
Prog Urol. 2008 Dec;18(12):989-91. doi: 10.1016/j.purol.2008.09.019. Epub 2008 Oct 16.
Stones in renal caliceal diverticula with no symptom or infection can be managed with surveillance. In other cases, extracorporeal lithotripsy (ESWL) can be the first line treatment for all diverticular stones, whatever their renal location. In case of ESWL failure, the procedure choice depends of the location of the diverticulum. Percutaneous surgery is indicated for lower and posterior diverticula. The puncture must be directly targeted to the stone. Flexible ureteroscopy is indicated for upper and mid, anterior or posterior, diverticula. Laparoscopy can be indicated for anterior, mid and lower or upper, diverticula. A medical evaluation and treatment must be systematic.
肾盏憩室内无症状或无感染的结石可通过监测处理。在其他情况下,无论憩室内结石位于肾脏何处,体外冲击波碎石术(ESWL)都可作为所有憩室结石的一线治疗方法。若ESWL治疗失败,手术方式的选择取决于憩室的位置。对于下极和后位憩室,建议行经皮手术。穿刺必须直接针对结石。对于上极、中极、前位或后位憩室,建议行软性输尿管镜检查。对于前位、中极和下极或上极憩室,可考虑行腹腔镜检查。必须进行系统的医学评估和治疗。