Kim Bum Soo
Department of Urology, Kyungpook National University School of Medicine, Daegu, Korea.
Korean J Urol. 2015 Sep;56(9):614-23. doi: 10.4111/kju.2015.56.9.614. Epub 2015 Sep 7.
Since its initial introduction in 1976, percutaneous nephrolithotomy (PCNL) has been widely performed for the management of large renal stones and currently is recommended for staghorn calculi, kidney stones larger than 2 cm, and shock wave lithotripsy-resistant lower pole stones greater than 1 cm. However, except for open and laparoscopic surgery, PCNL is the most invasive of the minimally invasive stone surgery techniques. Over the years, technical and instrumental advances have been made in PCNL to reduce morbidity and improve effectiveness. A thorough review of the recent literature identified five major areas of progress for the advancement of PCNL: patient positioning, method of percutaneous access, development of lithotriptors, miniaturized access tracts, and postoperative nephrostomy tube management. This review provides an overview of recent advancements in PCNL and the outcomes of each area of progress and notes how much we achieve with less invasive PCNL. This information may allow us to consider the future role and future developments of PCNL.
自1976年首次引入经皮肾镜取石术（PCNL）以来，该手术已被广泛应用于治疗大型肾结石，目前推荐用于鹿角形结石、直径大于2厘米的肾结石以及直径大于1厘米的冲击波碎石治疗无效的下极结石。然而，除开放手术和腹腔镜手术外，PCNL是微创结石手术技术中侵入性最强的。多年来，PCNL在技术和器械方面取得了进展，以降低发病率并提高疗效。对近期文献的全面回顾确定了PCNL进展的五个主要领域：患者体位、经皮穿刺入路方法、碎石器的发展、通道小型化以及术后肾造瘘管管理。本综述概述了PCNL的近期进展以及每个进展领域的结果，并指出我们通过侵入性较小的PCNL取得了多大的成效。这些信息可能使我们能够思考PCNL的未来作用和未来发展。
