Wong H Y, Hinson J L, Griffith D P
Department of Urology, Baylor College of Medicine, Houston, TX, USA.
J Endourol. 1995 Dec;9(6):461-3. doi: 10.1089/end.1995.9.461.
Establishment of a nephrostomy tract is a prerequisite for many endourologic procedures of the upper urinary tract. We reviewed our initial experience with 31 retrograde nephrostomies to determine the advantages and disadvantages and the learning curve for the procedure. All but one of the attempts were successful, and no complications were attributable to the nephrostomy puncture. The procedure time averaged 21.1 minutes in nondilated collecting systems but 32.0 minutes in hydronephrotic kidneys (P < 0.01). The mean procedure time in our first 10 successful cases was 36.2 minutes, but it decreased to 22.6 minutes in the second 10 successful cases (P < 0.02). Radiation exposure was also minimized early, with a mean fluoroscopy time of 3.5 minutes in our first 10 successful cases and 1.5 minutes in our second 10 successful cases (P < 0.02). Similarly, both procedure and fluoroscopy times decreased further in the most recent 10 successful cases. Retrograde nephrostomy is a safe procedure, is easier in a nondilated collecting system, and can be mastered with a short learning curve with minimal radiation exposure.
建立肾造瘘通道是许多上尿路腔内泌尿外科手术的前提条件。我们回顾了我们最初进行31例逆行肾造瘘术的经验，以确定该手术的优缺点及学习曲线。除1例尝试外，其余均成功，且无并发症归因于肾造瘘穿刺。在未扩张的集合系统中，手术时间平均为21.1分钟，但在肾积水的肾脏中为32.0分钟（P<0.01）。我们最初10例成功病例的平均手术时间为36.2分钟，但在随后10例成功病例中降至22.6分钟（P<0.02）。辐射暴露也在早期降至最低，最初10例成功病例的平均透视时间为3.5分钟，随后10例成功病例为1.5分钟（P<0.02）。同样，在最近10例成功病例中，手术时间和透视时间进一步缩短。逆行肾造瘘术是一种安全的手术，在未扩张的集合系统中更容易操作，且可在短时间学习曲线和最小辐射暴露的情况下掌握。
