Terachi T, Terai A, Machida S, Takeuchi H
Department of Urology, Kurashiki Central Hospital.
Hinyokika Kiyo. 1987 Dec;33(12):2020-6.
Percutaneous and transurethral removal of renal and ureteral calculi was performed in 109 cases. Targeted calculi were successfully removed in 105 cases (96.3 per cent), but in five cases combined percutaneous and transurethral procedures were required. Although endourological stone removal resulted in low morbidity rates in many other series, some major complications have also been reported. They include arteriovenous fistula, colo-cutaneous fistula, nephro-duodenal fistula and ureteral avulsion. There were two severe complications in our early experience as well. In one case, a ureteral stenosis was found seven months after two sessions of percutaneous ultrasonic lithotripsy for an upper ureteral stone, and in the other case, a mid-ureteral avulsion was caused by ureteroscopic manipulation. Besides these, we experienced several minor pelvic and ureteral perforations which were easily controlled only by ureteral stent placement. Causes and management of ureteral complications in endourological treatment of renal and ureteral calculi are discussed.
对109例患者进行了经皮和经尿道肾及输尿管结石取出术。105例（96.3%）患者的目标结石成功取出，但有5例需要联合经皮和经尿道手术。尽管在许多其他系列研究中，腔内泌尿外科取石术的发病率较低，但也有一些严重并发症的报道。这些并发症包括动静脉瘘、结肠皮肤瘘、肾十二指肠瘘和输尿管撕脱。在我们早期的经验中也有两例严重并发症。一例患者在接受两次经皮超声碎石术治疗上段输尿管结石七个月后发现输尿管狭窄，另一例患者因输尿管镜操作导致输尿管中段撕脱。除此之外，我们还遇到了几例轻微的盆腔和输尿管穿孔，仅通过放置输尿管支架就很容易控制。本文讨论了肾及输尿管结石腔内泌尿外科治疗中输尿管并发症的原因及处理方法。
