Maillet P J, Pelle-Francoz D, Pinet A
J Radiol. 1984 May;65(5):343-53.
130 percutaneous nephrostomies have been performed on 106 patients, 6 of whom had transplanted kidneys. On 4 of these patients percutaneous drainage of a perinephric abscess was performed at the same time. Over 50% of the patients were in obstructive anuria. No failure was noted in placement of the nephrostomy tubes. Only one major complication occurred, a resolvent septic shock. Minor complications i.e. pelvocalyceal blood clotting, catheter dislodgement, retroperitoneal urine extravasation, are rare. There is no contra-indication to this procedure. 30 indwelling ureteral catheters and 10 double pigtail stent catheters were also inserted by this antegrade technic. The main indications for these procedures are 1) acute or chronic supravesical obstructions, especially infected cases. The therapeutic decision is often difficult in stenosis of neoplastic origin 2) ureteral fistulas which are always dried by a nephrostomy and which can be definitely cured by indwelling catheters, 3) certain types of calculi, which can be either treated by irrigation in situ with stone-dissolving solutions, or removed percutaneously by extraction or ultrasonic lithotripsy.
已对106例患者实施了130次经皮肾造瘘术，其中6例患者为肾移植受者。在这6例患者中，有4例同时进行了经皮肾周脓肿引流。超过50%的患者处于梗阻性无尿状态。肾造瘘管置入未出现失败情况。仅发生了1例严重并发症，即感染性休克，但已缓解。轻微并发症，如肾盂肾盏血凝块形成、导管移位、腹膜后尿液外渗等较为罕见。该手术无禁忌证。还通过这种顺行技术插入了30根留置输尿管导管和10根双猪尾支架导管。这些手术的主要适应证为：1）急性或慢性膀胱上尿路梗阻，尤其是感染病例。对于肿瘤源性狭窄，治疗决策往往较为困难；2）输尿管瘘，肾造瘘可使其始终保持干燥，留置导管可将其彻底治愈；3）某些类型的结石，可通过原位灌注溶石溶液进行治疗，或通过经皮取出或超声碎石术予以清除。
