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经皮取石术的并发症

[Complications in percutaneous lithotomy].

作者信息

Ritter M, Rassweiler M-C, Michel M S

机构信息

Klinik für Urologie, Universitätsmedizin Mannheim, Ruprecht-Karls-Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland,

出版信息

Urologe A. 2014 Jul;53(7):1011-6. doi: 10.1007/s00120-014-3503-7.

Abstract

BACKGROUND

Percutaneous lithotomy is the gold standard in the treatment of large kidney stones. Several steps of the operation might cause severe complications. Safe procedures depend on careful planning, accurate performance, recognition of problems and knowledge of how to handle them.

OBJECTIVES

Relevant steps of percutaneous stone treatment with possible complications and their management are presented.

MATERIALS AND METHODS

Current topics in percutaneous stone treatment taking into consideration the relevant literature are discussed. Furthermore, rare complications and strategies for safe management are presented.

RESULTS

Careful planning and adequate preoperative diagnostic workup are essential for safe procedures. Puncture of the renal calyceal system and tract dilation might lead to severe complications. Bleeding and infectious complications are the most common problems. Availability of interventional radiology provides ideal emergency treatment in case of severe bleeding and helps to avoid surgical revision with high risk of organ loss.

CONCLUSIONS

Percutaneous stone treatment is a safe and effective therapy in an experienced physician's hands. Careful planning and accurate performance help to avoid severe complications.

摘要

背景

经皮肾镜取石术是治疗大型肾结石的金标准。手术的几个步骤可能会导致严重并发症。安全的手术过程取决于精心规划、准确操作、对问题的识别以及处理问题的知识。

目的

介绍经皮肾镜取石术的相关步骤、可能出现的并发症及其处理方法。

材料与方法

讨论了经皮肾镜取石术当前的相关主题,并参考了相关文献。此外,还介绍了罕见并发症及安全处理策略。

结果

精心规划和充分的术前诊断检查对于安全手术至关重要。肾盏系统穿刺和通道扩张可能导致严重并发症。出血和感染并发症是最常见的问题。介入放射学的应用为严重出血提供了理想的紧急治疗手段,有助于避免因高风险的器官切除而进行的手术翻修。

结论

在经验丰富的医生手中,经皮肾镜取石术是一种安全有效的治疗方法。精心规划和准确操作有助于避免严重并发症。

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