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腹腔镜输尿管-肾结石手术的适应证和结果。

Indications and outcomes of laparoscopic uretero-renal stone surgery.

机构信息

Paracelsus Medical University Salzburg, Department of Urology and Andrology, Salzburg, Austria.

出版信息

Curr Opin Urol. 2011 Mar;21(2):161-5. doi: 10.1097/MOU.0b013e3283430afc.

Abstract

PURPOSE OF REVIEW

Although most ureteral and urinary stones are managed using endourologic techniques or shockwave lithotripsy in daily clinical practice, stone surgery has not completely disappeared. Laparoscopy, another minimally invasive treatment, is continuously gaining place in the treatment of urinary stones, mainly replacing open surgery.

RECENT FINDINGS

Indications for open or laparoscopic stone surgery are anatomic abnormalities, such as horseshoe kidneys, malrotated kidneys, ureteropelvic junction obstruction with stones, or ectopic kidneys; symptomatic stones in diverticula; extremely large stones and all those situations in which conventional endourologic procedures and extracorporeal shock-wave lithotripsy are not available or were unsuccessful or in those conditions where laparoscopy offers a priori the best solution to an endourologic complex condition.

SUMMARY

Laparoscopic surgery is effective for complex urinary stones and allows adjunctive procedures. It complements other minimally invasive procedures, and a need for open surgery has strongly diminished.

摘要

目的综述

虽然在日常临床实践中,大多数输尿管和尿路结石都采用腔内泌尿外科技术或体外冲击波碎石术进行治疗,但结石手术并未完全消失。腹腔镜手术作为另一种微创治疗方法,在尿路结石的治疗中不断获得一席之地,主要替代开放性手术。

最近的发现

开放性或腹腔镜结石手术的适应证为解剖异常,如马蹄肾、旋转不良的肾脏、肾盂输尿管交界处结石合并梗阻或异位肾脏;憩室内有症状的结石;非常大的结石以及所有传统腔内泌尿外科手术和体外冲击波碎石术不可用或不成功的情况,或者在腹腔镜为腔内泌尿外科复杂情况提供最佳解决方案的情况下。

总结

腹腔镜手术对复杂的尿路结石有效,并可辅助进行其他微创手术。它补充了其他微创治疗方法,而开放性手术的需求大大减少。

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