Hosking D H
J Urol. 1986 Jun;135(6):1146-9. doi: 10.1016/s0022-5347(17)46019-8.
An attempt was made to establish a percutaneous nephrostomy in 47 consecutive patients using retrograde techniques. In all patients the Lawson nephrostomy system was used first. A steerable guide wire is used to position a polytetrafluoroethylene (Teflon) catheter in a suitable calix. A penetrating wire then is passed through the catheter and advanced to the skin. The catheter then is advanced over the wire to the abdominal wall and locked to the wire. Traction on the wire advances the catheter to the skin to establish the nephrostomy tract. If the Lawson system could not be used successfully, the Hunter-Hawkins nephrostomy system was used. Of the patients studied 3 required bilateral nephrostomy and 1 required 2 nephrostomies in the same kidney, for a total of 51 attempted procedures. Of the 51 attempts 49 (96 per cent) were successful. Nephrostomy was done for stone removal in 46 cases and was successful. The Lawson system was used successfully in 43 of the 49 successful nephrostomies (88 per cent). The Hunter-Hawkins system was successful in the remaining 6 patients. The mean duration of the nephrostomy procedure was 45.9 minutes and the mean fluoroscopy time was 2.7 minutes. No patient suffered any complication related to the nephrostomy insertion. Retrograde nephrostomy is a quick, safe procedure that requires little radiation and is well suited to the undilated collecting system.
对47例连续患者尝试采用逆行技术建立经皮肾造瘘术。所有患者均首先使用劳森肾造瘘系统。使用可操纵导丝将聚四氟乙烯（特氟龙）导管置于合适的肾盏中。然后将一根穿刺导丝穿过导管并推进至皮肤。接着将导管沿导丝推进至腹壁并固定于导丝。牵拉导丝使导管推进至皮肤以建立肾造瘘通道。如果无法成功使用劳森系统，则使用亨特 - 霍金斯肾造瘘系统。在研究的患者中，3例需要双侧肾造瘘，1例在同一肾脏需要进行2次肾造瘘，共计尝试了51次操作。在这51次尝试中，49次（96%）成功。46例为取石而行肾造瘘且成功。在49次成功的肾造瘘中，43次（88%）成功使用了劳森系统。其余6例患者使用亨特 - 霍金斯系统成功。肾造瘘术的平均持续时间为45.9分钟，平均透视时间为2.7分钟。没有患者出现与肾造瘘置入相关的任何并发症。逆行肾造瘘是一种快速、安全的操作，辐射少，非常适合未扩张的集合系统。
