Ohlsén H, Kinn A C
Department of Diagnostic Radiology, Karolinska Hospital, Stockholm, Sweden.
Scand J Urol Nephrol. 1993;27(3):311-21. doi: 10.3109/00365599309180440.
Percutaneous extraction of 372 renal and proximal ureteral calculi was performed under fluoroscopic control in 202 consecutive patients. In 193 kidneys (90%) removal of stones was performed under fluoroscopic control only and in 10% initial ultrasonic disintegration was used. A completely stone free kidney was achieved in 74%. If successful outcome is defined as no stones or residual fragments less than 5 mm, the success rate was 91%. With a mean size of 10.3 mm 259 intact stones were extracted under fluoroscopic control. Open surgery was performed in 13 of 202 patients, in 10 of these cases due to unsuccessful removal of an impacted ureteral stone. Complications occurred in 16%, none of them were serious. Open intervention became necessary in 2 patients. Bleeding which required blood transfusion occurred once. Percutaneous renal stone extraction under fluoroscopy is safe and useful in selected patients when ESWL can be expected to produce less favourable results. The ability to perform this technique should therefore be well maintained.
在202例患者中，在荧光透视控制下经皮取出372颗肾及输尿管上段结石。193例肾脏（90%）仅在荧光透视控制下进行结石取出，10%的病例最初采用超声碎石。74%的肾脏结石完全清除。如果将成功结果定义为无结石或残留碎片小于5mm，则成功率为91%。平均大小为10.3mm的259颗完整结石在荧光透视控制下取出。202例患者中有13例进行了开放手术，其中10例是由于输尿管结石嵌顿取出失败。并发症发生率为16%，均不严重。2例患者需要进行开放干预。发生1次需要输血的出血情况。当预计体外冲击波碎石（ESWL）效果不佳时，荧光透视下经皮肾镜取石术对特定患者是安全且有用的。因此，应很好地掌握这项技术的操作能力。
