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[尿流改道后经皮输尿管造口术使用输尿管接入鞘逆行输尿管镜碎石术:一例报告]

[Retrograde Ureteroscopic Lithotripsy with Ureteral Access Sheath Via Cutaneous Ureterostomy after Urinary Diversion : A Case Report].

作者信息

Fukuda Tetsuo, Kawahata Ryo, Tajirika Hironao, Ishikawa Tatsuro, Matsuzaki Junichi

机构信息

The Department of Urology, Ohguchi Higashi General Hospital.

出版信息

Hinyokika Kiyo. 2024 Jan;70(1):17-19. doi: 10.14989/ActaUrolJap_70_1_17.

Abstract

A 65-year-old man presented with a history of rectal cancer 20 years prior that led to the development of a cutaneous ureterostomy and a colostomy. Subsequently, the patient was diagnosed with acute complicated pyelonephritis due to a right ureteral stone. After the placement of a single J ureteral stent in the right ureter for therapeutic management, the patient was referred to our institution for treatment of the right ureteral stone. An abdominal computed tomography (CT) revealed an 11×8 mm stone in the upper right ureter. A 10/12 Fr ureteral access sheath was inserted through the cutaneous ureterostomy and retrograde ureteroscopic lithotripsy was performed. Although a febrile urinary tract infection appeared postoperatively, the patient was discharged on the sixth postoperative day. At postoperative 1-month, CT showed no residual stones and no hydronephrosis. The use of a ureteral access sheath in performing retrograde ureteroscopic lithotripsy effectively managed the ureteral stone with cutaneous ureterostomy.

摘要

一名65岁男性,20年前有直肠癌病史,导致皮肤输尿管造口术和结肠造口术。随后,该患者因右侧输尿管结石被诊断为急性复杂性肾盂肾炎。在右侧输尿管置入单根J型输尿管支架进行治疗后,患者被转诊至我院治疗右侧输尿管结石。腹部计算机断层扫描(CT)显示右上输尿管有一枚11×8 mm的结石。通过皮肤输尿管造口插入10/12 Fr输尿管通路鞘,并进行逆行输尿管镜碎石术。尽管术后出现发热性尿路感染,但患者术后第6天出院。术后1个月,CT显示无残留结石,无肾积水。在进行逆行输尿管镜碎石术时使用输尿管通路鞘有效地处理了伴有皮肤输尿管造口术的输尿管结石。

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