Van Savage J G, Khoury A E, McLorie G A, Churchill B M
Department of Surgery, Hospital for Sick Children, University of Toronto, Ontario, Canada.
J Urol. 1996 Aug;156(2 Pt 2):706-8. doi: 10.1097/00005392-199608001-00038.
The number of vesical calculi is increasing as the number of patients with intestinocystoplasty increases. We describe our technique for easily removing vesical calculi in children via an atraumatic percutaneous endoscopic approach.
The procedure involves percutaneous suprapubic puncture and direct visualization of the calculi via cystoscopy through the urethra or via a second suprapubic puncture when the bladder neck is closed. The stones are vacuumed up 1 at a time with suction tubing through the suprapubic working sheath in a controlled manner with no urethral trauma. Ten patients 3 to 16 years old (mean age 8) with vesicolithiasis underwent percutaneous vacuum vesicolithotomy under direct vision in 1993 to 1995.
Two to 12 bladder calculi were extracted (mean 7). All calculi less than 1 cm. were removed by this procedure. All bladder calculi between 1 and 1.5 cm. were also removed but they required simultaneous electrohydraulic lithotripsy. There were no complications at a mean 1-year followup. Mean hospitalization was less than 24 hours (range 0 to 3 days).
Percutaneous vacuum vesicolithotomy is highly successful, easy to perform and safe for extracting vesical calculi. Since the procedure is done through a percutaneous sheath, it is particularly suited to the individual with an absent, small caliber, sensitive or surgically reconstructed urethra.
随着膀胱扩大术患者数量的增加，膀胱结石的数量也在上升。我们描述了一种通过无创经皮内镜方法轻松去除儿童膀胱结石的技术。
该手术包括经皮耻骨上穿刺，当膀胱颈关闭时，可通过尿道膀胱镜直接观察结石，或通过第二次耻骨上穿刺进行观察。结石通过耻骨上工作鞘，利用吸引管每次以可控方式逐个吸出，不会造成尿道损伤。1993年至1995年，10例3至16岁（平均年龄8岁）的膀胱结石患者在直视下接受了经皮真空膀胱结石切除术。
共取出2至12枚膀胱结石（平均7枚）。所有小于1厘米的结石均通过此方法取出。所有1至1.5厘米的膀胱结石也被取出，但需要同时进行液电碎石术。平均随访1年无并发症。平均住院时间少于24小时（0至3天）。
经皮真空膀胱结石切除术在取出膀胱结石方面非常成功，操作简便且安全。由于该手术是通过经皮鞘进行的，特别适合尿道缺如、管径小、敏感或经手术重建的患者。
