Naito K, Hisazumi H, Oshinoya Y, Uchibayashi T, Misaki T
Department of Urology, School of Medicine, Kanazawa University.
Hinyokika Kiyo. 1989 May;35(5):763-7.
One hundred and four consecutive patients with renal and/or ureteral calculi, 66 males and 38 females with an average age of 44.3 years ranging from 17 to 83, were treated by a percutaneous procedure between September, 1984 and October, 1987. In an early series of 6 patients, a two-stage procedure consisting of temporary renal drainage and the introduction of an endoscope a few days later was employed. The remaining 98 patients received a so-called one-stage procedure. The stone was removed successfully in 96 patients with an average operation time of 140 minutes. In 2 of the 96 patients, renal stones recurred 7 months and 20 months later. The most common cause for failure in stone removal was the difficulty of engaging calyceal stones and ureteral stones using a basket and/or 3-prong grasper, because of inflammatory mucosa adhering to the stones. Out of 8 failures, 7 and 1 required an open operation and trans-urethral intervention, respectively. There were 40 complications in 33 patients. Of 11 patients in whom renal pelvic perforation occurred, 2 required open surgical repair. Of 5 patients complaining of renal bleeding, 1 required renal artery embolization. With increasing experience and improving procedure, most renal, and upper and mid ureteral stones have been safely and successfully removed percutaneously.
1984年9月至1987年10月期间,对104例连续性肾和/或输尿管结石患者进行了经皮手术治疗,其中男性66例,女性38例,平均年龄44.3岁,年龄范围为17至83岁。在早期的6例患者中,采用了两阶段手术,即先进行临时肾引流,几天后再插入内窥镜。其余98例患者接受了所谓的一阶段手术。96例患者结石成功取出,平均手术时间为140分钟。在这96例患者中,有2例分别在7个月和20个月后肾结石复发。结石取出失败的最常见原因是由于炎性黏膜附着于结石,使用网篮和/或三爪抓钳难以夹住肾盏结石和输尿管结石。在8例失败病例中,分别有7例和1例需要进行开放手术和经尿道干预。33例患者出现了40例并发症。在发生肾盂穿孔的11例患者中,2例需要进行开放手术修复。在5例主诉肾出血的患者中,1例需要进行肾动脉栓塞。随着经验的增加和手术方法的改进,大多数肾、输尿管上段和中段结石已通过经皮手术安全、成功地取出。