Streem S B
Department of Urology, Cleveland Clinic Foundation, Ohio.
Semin Urol. 1989 Feb;7(1):30-8.
The recent introduction of endoscopic technology specifically designed to provide access to the upper tracts has quickly become accepted as a routine part of the urologic armanentarium. Diagnostic ureteropyeloscopy clearly has an important role for those patients in whom the etiology of a filling defect or obstructing lesion cannot be determined by standard techniques. Additionally, ureteropyeloscopy offers the option of direct visual biopsy. In our experience, transureteroscopic biopsy has been most valuable when a tumor has been visualized in the setting of negative urine cytology. Transureteroscopic biopsy has also proven useful when preoperative knowledge of tumor grading or even pathologic staging may change the ultimate surgical approach. In fact, the role of transureteroscopic biopsy is becoming similar in many respects to cystoscopic biopsy. As such, it is not difficult to predict the further evolution of ureteropyeloscopy from a diagnostic procedure to a routine therapeutic modality utilized for a wide range of urologic disorders. With increasing experience, it has become evident that the initial optimism for ureteropyeloscopy was well founded and the expectations have already been met or have even been exceeded.
最近专门设计用于进入上尿路的内镜技术已迅速被接受为泌尿外科器械库的常规组成部分。对于那些通过标准技术无法确定充盈缺损或梗阻性病变病因的患者，诊断性输尿管肾盂镜检查显然具有重要作用。此外，输尿管肾盂镜检查提供了直接可视活检的选择。根据我们的经验，当在尿液细胞学检查阴性的情况下发现肿瘤时，经输尿管镜活检最有价值。当术前了解肿瘤分级甚至病理分期可能改变最终手术方式时，经输尿管镜活检也已证明是有用的。事实上，经输尿管镜活检在许多方面的作用正变得与膀胱镜活检相似。因此，不难预测输尿管肾盂镜检查将从一种诊断程序进一步演变为用于广泛泌尿外科疾病的常规治疗方式。随着经验的增加，越来越明显的是，对输尿管肾盂镜检查最初的乐观态度是有充分根据的，并且预期已经实现甚至已经被超越。
