Inoue Takaaki, Okada Shinsuke, Hamamoto Shuzo, Fujisawa Masato
Department of Urology and Stone Center, Hara Genitourinary Hospital, Kobe, Hyogo, Japan.
Department of Urology, Kobe University, Kobe, Hyogo, Japan.
Investig Clin Urol. 2021 Mar;62(2):121-135. doi: 10.4111/icu.20200526.
With the recent technological advancements in endourology, retrograde intrarenal surgery has become a more popular procedure for treatment of urolithiasis. Furthermore, since the introduction of new laser systems and advanced flexible ureteroscopy with miniaturized ureteroscopes, the treatment indications for retrograde intrarenal surgery have expanded to include not only larger renal stones of >2 cm but also upper urinary tract urothelial carcinoma, ureteral stricture, and idiopathic renal hematuria. Clinicians must keep up with these trends and make good use of these technologies in the rapidly changing field of endourology. Simultaneously, we must consider the risk of various complications including thermal injury due to laser use, ureteral injury caused by the ureteral access sheath, and radiation exposure during retrograde intrarenal surgery with fluoroscopic guidance. This review focuses on the past, present, and future of retrograde intrarenal surgery and provides many topics and clinical options for urologists to consider.
随着腔内泌尿外科技术的最新进展，逆行性肾内手术已成为治疗尿石症更常用的方法。此外，自从新型激光系统和配备小型输尿管镜的先进软性输尿管镜问世以来，逆行性肾内手术的治疗适应症已扩大，不仅包括大于2厘米的较大肾结石，还包括上尿路尿路上皮癌、输尿管狭窄和特发性肾血尿。临床医生必须跟上这些趋势，并在迅速变化的腔内泌尿外科领域充分利用这些技术。同时，我们必须考虑各种并发症的风险，包括激光使用导致的热损伤、输尿管进入鞘引起的输尿管损伤以及在荧光镜引导下逆行性肾内手术期间的辐射暴露。本综述聚焦于逆行性肾内手术的过去、现在和未来，并为泌尿外科医生提供了许多需要考虑的主题和临床选择。
