Mokulis J A, Peretsman S J
Department of Urology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, TX, USA.
J Endourol. 1997 Apr;11(2):125-30. doi: 10.1089/end.1997.11.125.
Percutaneous nephrolithotomy remains an important technique for managing complicated nephrolithiasis. Retrograde percutaneous nephrostomy creation has been promoted as an alternative to the standard antegrade technique. We reviewed our first 41 consecutive attempts utilizing the Lawson technique for managing patients with complicated nephrolithiasis. Percutaneous access was achieved in 40 attempts (98%). Thirty-six (90%) of the retrograde nephrostomy tracts were adequate for lithotripsy or stone extraction during the same anesthetic. Twenty-three (56%) of the kidneys treated with the Lawson procedure were rendered stone free. Nine patients had minimal residual stone burden (fewer than five fragments, 4 mm or smaller) by the time of discharge. A single Lawson procedure rendered 10 kidneys (24%) stone free. An additional 20 clinic procedures and 17 anesthetic procedures were performed on the 40 kidneys. Complications were minimal, with three patients (8%) requiring transfusion.
经皮肾镜取石术仍然是处理复杂性肾结石的一项重要技术。逆行经皮肾造瘘术已被推广作为标准顺行技术的替代方法。我们回顾了我们最初连续41次使用劳森技术处理复杂性肾结石患者的尝试。40次尝试（98%）成功建立了经皮通道。36条（90%）逆行肾造瘘通道在同一麻醉期间足以进行碎石或取石。采用劳森手术治疗的肾脏中有23个（56%）实现了无石。9名患者出院时残余结石负荷极小（少于5个碎片，直径4毫米或更小）。单次劳森手术使10个肾脏（24%）实现了无石。对这40个肾脏又进行了20次门诊手术和17次麻醉操作。并发症极少，3名患者（8%）需要输血。
