Lingam K, Paterson P J, Lingam M K, Buckley J F, Forrester A
Department of Urology, Royal Infirmary, Glasgow, England.
J Urol. 1994 Jul;152(1):70-2. doi: 10.1016/s0022-5347(17)32819-7.
Nephrostomy has been the standard method of urinary diversion when placement of ureteral stents has failed in cancer patients. We describe our early experience with an alternative method of urinary diversion, the subcutaneous urinary diversion. This extra-anatomical urinary diversion was done in 5 patients during a 15-month interval. The diversion is created using a specially designed 7F double pigtail stent. The proximal end of the stent is inserted into the renal pelvis via a percutaneous nephrostomy puncture. A subcutaneous tunnel is created from the flank to the bladder down which the distal end of the stent is passed and via a suprapubic bladder puncture the stent is passed into the bladder. The stent is changed at 4-month intervals over a guide wire. Our early experience with this extra-anatomical method of urinary diversion suggests it to be a safe, effective and acceptable alternative to nephrostomy that improves quality of life.
对于癌症患者，当输尿管支架置入失败时，肾造瘘术一直是尿液改道的标准方法。我们描述了我们在尿液改道替代方法——皮下尿液改道方面的早期经验。在15个月的时间里，对5例患者进行了这种非解剖学的尿液改道。使用专门设计的7F双猪尾支架进行改道。支架近端经皮肾造瘘穿刺插入肾盂。从侧腹至膀胱建立皮下隧道，支架远端经此隧道通过，再经耻骨上膀胱穿刺将支架置入膀胱。每隔4个月通过导丝更换支架。我们在这种非解剖学尿液改道方法上的早期经验表明，它是一种安全、有效且可接受的肾造瘘术替代方法，可改善生活质量。
