Hunter P T, Finlayson B, Drylie D M, Leal J, Hawkins I F
J Urol. 1985 Mar;133(3):369-74. doi: 10.1016/s0022-5347(17)48981-6.
We used a new technique, retrograde nephrostomy, to provide intrarenal access for percutaneous calculus removal in 30 consecutive patients. Under fluoroscopic control, we maneuvered cystoscopically a 5F and 9F coaxial catheter pair over a guide wire into the calix selected for nephrostomy. Then, a sheathed 20 to 21 gauge needle was passed through the 9F catheter into the flank to create the nephrostomy. Eight patients were given general and 22 intravenous sedation and local anesthesia for nephrostomy placement and calculus removal. Retrograde nephrostomy and subsequent calculus removal were completed successfully in 90 and 83 per cent of the 30 patients, respectively. There were 6 complications and 3 failures among the first few patients due to inferior equipment and inexperience with the technique. Over-all, we found that retrograde nephrostomy provided reliable, precise intrarenal access and we believe that it could become an alternative technique to aid in percutaneous calculus removal procedures.
我们采用了一种新技术——逆行肾造瘘术，为连续30例患者经皮肾镜取石术提供肾内通路。在荧光透视控制下，我们经膀胱镜将一根5F和一根9F同轴导管沿导丝操作至选定用于肾造瘘的肾盏。然后，将一根带鞘的20至21号穿刺针经9F导管刺入侧腹以建立肾造瘘。8例患者在进行肾造瘘置管和结石清除时接受了全身麻醉，22例接受了静脉镇静和局部麻醉。在30例患者中，逆行肾造瘘术及随后的结石清除术分别成功完成了90%和83%。由于设备欠佳和技术经验不足，最初的几名患者出现了6例并发症和3例失败。总体而言，我们发现逆行肾造瘘术能提供可靠、精确的肾内通路，我们认为它可成为有助于经皮肾镜取石术的一种替代技术。
