上尿路医源性异物的腔内处理

Endoscopic treatment of iatrogenic upper tract foreign bodies

目的 :探讨使用腔内技术处理上尿路异物的有效性与安全性。方法 :采用逆行输尿管镜术或结合微创经皮肾技术共处理 2 8例上尿路医源性异物 ,均为放置双J管引起 ,其中双J管石垢形成 12例 ,双J管远端上移8例 ,拔管困难 3例 ,双J管断端残留于肾内 5例。结果 :2 1例采用逆行输尿管镜术取出异物 ,7例结合微创经皮肾技术处理成功 ,手术成功率 10 0 %。随访 4 2 1个月 ,平均 7个月 ,无手术相关并发症发生。结论 :腔内技术处理上尿路异物安全、有效 ,对患者的创伤小。

Objective: To assess the efficacy and safety of endoscopic treatment of upper tract foreign bodies. Method: We performed retrograde ureteroscopy and/or 'mini perc' technique in 28 patients with iatrogenic upper tract foreign bodies result from retained ureteral stents. 12 patients had severely encrusted JJ ureteral stent, 8 were proximal stent migration, 3 difficult removal and 5 fragment of stent in the kidney. Result:Twenty-one cases were managed by ureteroscopy alone, and 7 managed by ureteroscopic and percutaneous approach simultaneously. The overall success rate was 100%. Follow-up was 4 to 21 monthes(mean 7monthes), no patient had complications. Conclusion: Endoscopic treatment of upper tract foreign bodies is safe, effective and has minimal morbidity.