Strittmatter F, Bader M J
Urologische Klinik und Poliklinik, LMU München, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
UroClinic München an der Oper, Residenzstraße 18, München, Deutschland.
Urologe A. 2019 Nov;58(11):1289-1297. doi: 10.1007/s00120-019-01034-6.
Ureterorenoscopy and percutaneous nephrolitholapaxy are minimally invasive procedures and are the standard procedures for the treatment of kidney stones and ureteral calculi. To achieve an adequate view, in both methods an optimal and sufficient irrigation flow is necessary. The intrarenal pressure is influenced by the irrigation pressure and irrigation volume and has to be controlled. Pathologically elevated intrarenal pressure can lead to irreversible damage of the kidneys. Lasers are frequently used for stone fragmentation. It has been shown in studies that the laser energy can lead to an increase in the temperature and that thermal effects can also damage the kidneys. This article provides the surgeon with an overview about the effects of temperature and pressure changes during ureterorenoscopy and percutaneous nephrolitholapaxy and how damages can be avoided.
输尿管肾镜检查和经皮肾镜取石术是微创手术，也是治疗肾结石和输尿管结石的标准手术。为了获得足够的视野，在这两种手术方法中都需要最佳且充足的冲洗流量。肾内压力受冲洗压力和冲洗量的影响，必须加以控制。病理性升高的肾内压力可导致肾脏不可逆损伤。激光常用于结石破碎。研究表明，激光能量可导致温度升高，热效应也会损害肾脏。本文为外科医生概述输尿管肾镜检查和经皮肾镜取石术期间温度和压力变化的影响以及如何避免损伤。
