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一种改良的马勒科特导管设计，用于预防困难经皮肾造瘘术期间的并发症。

A modified Malecot catheter design to prevent complications during difficult percutaneous nephrostomy.

作者信息

Sonawane Parag, Ganpule Arvind, B Sudharsan, Singh Abhishek, Sabnis Ravindra, Desai Mahesh

机构信息

Department of Urology, Muljibhai Patel Urological Hospital, Nadiad, India.

出版信息

Arab J Urol. 2019 Jun 27;17(4):330-334. doi: 10.1080/2090598X.2019.1626587. eCollection 2019.

DOI:10.1080/2090598X.2019.1626587
PMID:31723452
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6830246/
Abstract

: To demonstrate the feasibility of using a modified Malecot catheter with a proximal end adapter as compared to the conventional Malecot catheter, and demonstrate the technique of performing a contrast study without removing the guidewire (GW). : A modified 14-F Malecot catheter with a new proximal end connector with one side channel was used for percutaneous nephrostomy (PCN) under fluoroscopy guidance in five patients. The modified Malecot catheter was introduced over the GW under fluoroscopy guidance. The contrast study was done using the side channel of the connector whilst the GW was through the main channel. Five senior urologists were asked to assess the modified Malecot catheter by rating their experience on a 5-point Likert scale, which had three items. In a further five patients, the same urologists performed PCN using a conventional Malecot catheter and again rated their experience on the same Likert scale. : Total procedure time, fluoroscopy time, and ease of insertion were comparable in the two groups; however, the ease of the contrast study, security of correct positioning, and overall assessment were reported to be better with the modified Malecot catheter. : The modified Malecot design allows for easy percutaneous access comparable to the conventional Malecot catheter, with the advantages of ease of performing a contrast study and better security of correct positioning. GW: guidewire; PCN: percutaneous nephrostomy; PCS: pelvicalyceal system.

摘要

目的

与传统马勒科特导管相比，证明使用带有近端适配器的改良马勒科特导管的可行性，并展示在不取出导丝（GW）的情况下进行造影检查的技术。方法：使用带有一侧通道的新型近端连接器的改良14F马勒科特导管，在透视引导下对5例患者进行经皮肾造瘘术（PCN）。在透视引导下，将改良马勒科特导管经导丝置入。在导丝经主通道的同时，通过连接器的侧通道进行造影检查。邀请5位资深泌尿外科医生，通过5级李克特量表对改良马勒科特导管进行评估，该量表有三个项目。另外5例患者中，相同的泌尿外科医生使用传统马勒科特导管进行PCN，并再次用相同的李克特量表对他们的经验进行评分。结果：两组的总手术时间、透视时间和插入难易程度相当；然而，据报告改良马勒科特导管在造影检查的便利性、正确定位的安全性和总体评估方面更好。结论：改良马勒科特设计与传统马勒科特导管相比，允许轻松的经皮穿刺进入，具有便于进行造影检查和更好的正确定位安全性的优点。GW：导丝；PCN：经皮肾造瘘术；PCS：肾盂肾盏系统

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5304/6830246/c12d7624dcd0/TAJU_A_1626587_F0005_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5304/6830246/5226c807024b/TAJU_A_1626587_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5304/6830246/ce5edd3956e7/TAJU_A_1626587_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5304/6830246/5034bc7fce08/TAJU_A_1626587_F0003_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5304/6830246/8785d6d2cd7c/TAJU_A_1626587_F0004_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5304/6830246/c12d7624dcd0/TAJU_A_1626587_F0005_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5304/6830246/5226c807024b/TAJU_A_1626587_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5304/6830246/ce5edd3956e7/TAJU_A_1626587_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5304/6830246/5034bc7fce08/TAJU_A_1626587_F0003_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5304/6830246/8785d6d2cd7c/TAJU_A_1626587_F0004_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5304/6830246/c12d7624dcd0/TAJU_A_1626587_F0005_OC.jpg

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本文引用的文献

1
Radiolucent handle for percutaneous puncture under continuous fluoroscopic monitoring.用于在连续透视监测下经皮穿刺的射线可透手柄。
Radiology. 1981 Nov;141(2):538. doi: 10.1148/radiology.141.2.7291585.
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Percutaneous nephrostomy--technique.经皮肾造瘘术——技术
Urol Radiol. 1981;2(3):131-9. doi: 10.1007/BF02926714.
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Dual stiffness Malecot (Stamey) catheter.双硬度马勒科特（斯塔米）导管。
Radiology. 1984 Jul;152(1):225. doi: 10.1148/radiology.152.1.6729121.