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[使用软性肾输尿管镜经尿道输尿管肾镜碎石术的经验]

[Experience with transurethral uretero-nephrolithotripsy using flexible nephro-ureteroscope].

作者信息

Abe R, Etori K, Kato T, Sato K

机构信息

Department of Urology, Seirei Numazu Hospital.

出版信息

Nihon Hinyokika Gakkai Zasshi. 1990 Nov;81(11):1667-74. doi: 10.5980/jpnjurol1989.81.1667.

Abstract

Disintegration of urinary stones by electrohydraulic lithotripsy (EHL) under transurethral flexible nephro-ureteroscopy was performed for 39 renal and ureteral stones in 38 patients. The use of a ureteral guide tube facilitated the endoscopic manipulation and allowed the endoscope to access the stones in all cases except for two with a severe ureteral stricture. Thirty-seven of the 39 stones (94.9%) were successfully disintegrated and 35 stones (89.7%) were distracted. And 33 stones were completely excreted within 6 months (average, 27.9 days). Complications including ureteral perforation in 3 cases, one of whom required open ureterolithotomy, urinary extravasation in one, failure of removing the ureteral stent in one and perirenal abscess in one who underwent surgical incision. The transurethral flexible endoscope provides a clear vision in the whole urinary tract up to the renal calyx with a minimal complication. This technique could be used as a non-invasive treatment of urolithiasis adjunct to extracorporeal shock wave lithotripsy (ESWL), and also it could be an effective measure for other urological diseases such as the upper urinary tract tumors.

摘要

在38例患者中,对39颗肾和输尿管结石进行了经尿道软性肾输尿管镜下的电液压碎石术(EHL)。除2例输尿管严重狭窄患者外,使用输尿管引导管有助于内镜操作,并使内镜在所有病例中都能触及结石。39颗结石中的37颗(94.9%)成功碎石,35颗结石(89.7%)被粉碎。33颗结石在6个月内完全排出(平均27.9天)。并发症包括3例输尿管穿孔,其中1例需要行开放性输尿管切开取石术;1例尿外渗;1例输尿管支架取出失败;1例肾周脓肿,该患者接受了手术切开引流。经尿道软性内镜可清晰观察整个尿路直至肾盏,并发症极少。该技术可作为体外冲击波碎石术(ESWL)治疗尿路结石的非侵入性辅助手段,也可作为治疗上尿路肿瘤等其他泌尿系统疾病的有效措施。

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