Chang R, Marshall F F
J Urol. 1987 Jun;137(6):1132-5. doi: 10.1016/s0022-5347(17)44427-2.
Ureteroscopy is an important technique in the management of calculous disease and ureteral lesions but it appears to have a greater potential for injury than percutaneous nephroscopy. In 2 years 4 patients with severe ureteroscopic injuries were treated. In 3 patients complete obstruction of the ureter occurred, and 1 had a major ureteral tear, prolonged urinary extravasation and infection. Even in the presence of total ureteral occlusion patients with short strictures were managed successfully percutaneously but the 2 patients with longer strictures were not. Previous surgery on the ureter or pelvic surgery and radiation therapy appear to be negative factors that affect adversely the ureteral blood supply, and potentiate poor healing and scarring. Nephrostomy tube drainage and ureteral stenting after ureteral dilation appear to be important steps in the percutaneous management of these patients.
输尿管镜检查是治疗结石病和输尿管病变的一项重要技术，但与经皮肾镜检查相比，它造成损伤的可能性似乎更大。在两年时间里，共治疗了4例严重输尿管镜检查损伤患者。其中3例发生输尿管完全梗阻，1例出现输尿管严重撕裂、长时间尿外渗和感染。即使在输尿管完全闭塞的情况下，短段狭窄的患者经皮治疗成功，但2例长段狭窄的患者治疗未成功。先前的输尿管手术、盆腔手术和放射治疗似乎是对输尿管血供产生不利影响的负面因素，会加剧愈合不良和瘢痕形成。输尿管扩张后置入肾造瘘管引流和输尿管支架似乎是这些患者经皮治疗的重要步骤。
