Rosdy E
Department of Urology, Bajcsy-Zsilinszky Hospital, Budapest, Hungary.
Acta Chir Hung. 1987;28(3):217-22.
The advantages of percutaneous nephrolithotomy are reviewed and the difficulties are pointed out. During more than 100 successful nephrolithotomies it was found that stones or their fragments often drift away during manipulation into lateral or upper calices which cannot be visualized by a rigid nephroscope. Thus, removal of calculi was possible only by an auxiliary manipulation and so it took more time. To prevent this, an occlusive catheter was introduced, simultaneously with the ureteral catheter, into the renal cavital system and by blocking the balloon, the orifice of the calices was closed. In the case of multiple stones, two calices were simultaneously punctured and the two nephroscopes introduced were alternately applied during ultrasonic crushing of the stone, depending on which of the two instruments was closer. The modifications introduced by the author have significantly reduced the time of the operation and increased the effectivity of the procedure.
回顾了经皮肾镜取石术的优点并指出了困难之处。在100多例成功的肾镜取石术中发现，在操作过程中结石或其碎片常常漂入无法通过硬性肾镜观察到的外侧或上盏。因此，只能通过辅助操作来取出结石，这就花费了更多时间。为防止这种情况，在插入输尿管导管的同时，将一根闭塞导管插入肾腔系统，通过阻塞球囊封闭肾盏开口。对于多发结石，同时穿刺两个肾盏，在超声碎石时根据两个肾镜哪一个离结石更近，交替使用插入的两个肾镜。作者所做的改进显著缩短了手术时间并提高了手术效果。
