Segura J W
Mayo Clinic, Rochester, Minnesota.
Urol Clin North Am. 1990 Feb;17(1):207-16.
Appropriate management of the variety of patients with stone disease demands access to all methods of stone removal. Percutaneous procedures are an integral aspect of the surgical management of stone patients, and the urologist must recognize when a patient's situation is best served by percutaneous surgery. Percutaneous stone removal procedures are preferred when: 1. The stone is large, i.e., greater than 2 to 3 cm. 2. The stone is staghorn in configuration, with percutaneous measures being used either as primary treatment or in combination with shock wave lithotripsy. 3. The stone is composed of cystine 4. When certain removal of the stone is important. 5. When there is obstructive uropathy. 6. When other modalities have failed. 7. In morbidly obese individuals and others whose body habitus precludes use of the shock wave machine. 8. In children, at least until the issue of long-term safety of extracorporeal lithotripsy is settled.
对各类结石病患者进行恰当的治疗需要采用所有的结石清除方法。经皮手术是结石病手术治疗的一个重要方面，泌尿科医生必须认识到何时经皮手术最适合患者的病情。在以下情况下，经皮取石手术更为可取：1. 结石较大，即直径大于2至3厘米。2. 结石呈鹿角状，经皮治疗可作为主要治疗方法或与冲击波碎石术联合使用。3. 结石由胱氨酸组成。4. 结石的彻底清除很重要时。5. 存在梗阻性尿路病时。6. 其他治疗方式失败时。7. 病态肥胖个体以及因体型原因无法使用冲击波碎石机的其他患者。8. 对于儿童，至少在体外碎石术的长期安全性问题解决之前。
