Ikari O, Palma P C, D'Ancona C A
Division of Urology, University of Campinas Medical Center UNICAMP, Sao Paulo, Brazil.
J Urol. 1990 Oct;144(4):966-8. doi: 10.1016/s0022-5347(17)39634-9.
Nephrectomy is indicated for the removal of highly damaged kidneys. Several times patients are asymptomatic, and although the operation has a low morbidity rate they will refuse it. The development of new endourological techniques of percutaneous access to the kidney in experimental studies on liquefaction and aspiration of tissues, and the idea taken from the old resectoscope models using nonelectrical aids served to inspire our technique of percutaneous nephrectomy. Our patient presented with a nonfunctioning kidney due to ureteral obstruction and ultrasound demonstrated a severe decrease in renal parenchyma. Percutaneous access to the kidney was performed through the conventional manner and the remaining parenchyma was removed with biopsy and Lowsley forceps. Bleeding was minimum and a 22F nephrostomy Foley catheter was kept in place for 72 hours. As far as new instruments are developed, percutaneous nephrectomy represents a surgical option to remove nonfunctioning kidneys in highly selected patients.
肾切除术适用于切除严重受损的肾脏。患者多次无症状，尽管该手术的发病率较低，但他们仍会拒绝。在关于组织液化和抽吸的实验研究中，经皮进入肾脏的新腔内泌尿外科技术的发展，以及从使用非电辅助工具的旧电切镜模型中获得的想法，启发了我们的经皮肾切除术技术。我们的患者因输尿管梗阻导致肾脏无功能，超声显示肾实质严重减少。通过常规方式经皮进入肾脏，用活检钳和洛氏钳切除剩余的肾实质。出血极少，一根22F肾造瘘Foley导管留置72小时。随着新器械的不断研发，经皮肾切除术是为高度选择的患者切除无功能肾脏的一种手术选择。
