Beckmann C F, Roth R A
Urology. 1985 Mar;25(3):277-83. doi: 10.1016/0090-4295(85)90328-0.
The best results in percutaneous renal calculus removal are in patients with solitary pelvic stones and dilated collecting systems. Calyceal and/or infundibular calculi and ureteral calculi constitute more complex problems and are less successfully removed. Placement failure of the nephrostomy tube, and inability to gain access to calyceal calculi, and to engage impacted stones are the usual causes for unsuccessful procedures. To try to improve overall success we inserted occlusion balloon catheters prior to nephrostomy insertion in 60 of 71 patients. In a select group of 23 patients with a small renal pelvis and large calculi or infundibular calculi or patients with ureteral calculi, overnight application of 20 cm of hydrostatic pressure through the ureteric catheter led to marked dilatation in all instances. In all other patients the occlusion balloon catheter was placed immediately prior to the definitive nephrostolithotomy procedure. These ureteral catheters allow for better opacification and for dilatation of a small collecting system thereby facilitating the placement of the nephrostomy tube. They permit manipulation of calyceal and especially ureteral calculi. Placement of ureteral occlusion catheters is a safe adjunct to nephrostolithotomies and, in our experience, resulted in increased overall success.
经皮肾镜取石术在孤立盆腔结石且集合系统扩张的患者中取得的效果最佳。肾盏和/或漏斗部结石以及输尿管结石构成更复杂的问题，取石成功率较低。肾造瘘管置入失败、无法进入肾盏结石部位以及无法处理嵌顿结石是手术失败的常见原因。为提高总体成功率，我们在71例患者中的60例于插入肾造瘘管前插入了阻塞球囊导管。在一组特定的23例患者中，这些患者肾盂较小且结石较大或存在漏斗部结石，或者患有输尿管结石，通过输尿管导管施加20厘米的静水压力过夜，在所有情况下均导致明显扩张。在所有其他患者中，阻塞球囊导管在确定性肾切开取石术之前立即放置。这些输尿管导管可实现更好的显影，并使小集合系统扩张，从而便于肾造瘘管的置入。它们允许对肾盏结石尤其是输尿管结石进行操作。输尿管阻塞导管的置入是肾切开取石术的一种安全辅助手段，根据我们的经验，可提高总体成功率。
