MINIMALLY INVASIVE THERAPY OF URETERAL CALCULI

被引:8
作者
MARBERGER, M
HOFBAUER, J
TURK, C
ALBRECHT, W
机构
[1] Department of Urology, the University Vienna Medical School, Vienna
[2] Rudolfstiftung Hospital, Vienna
关键词
URETERAL CALCULI; ESWL INSITU; URETEROSCOPY; ENDOUROLOGY; LASER LITHOTRIPSY;
D O I
10.3109/13645709209152938
中图分类号
R61 [外科手术学];
学科分类号
摘要
As documented with results obtained in 1685 patients the treatment of ureteric stones is today based on extracorporeal shock wave lithotripsy (ESWL) in situ and ureteroscopy with semirigid, ultrathin ureteroscopes and laser lithotripsy. All stones in the upper third of the ureter and larger stones in the distal third of the ureter are preferably treated with ESWL in situ whereas smaller stones in the distal ureter are better treated endoscopically. Mid-ureteric stones remain the domain of primary ureteroscopy; with moderate obstruction in the asymptomatic patient it may also be acceptable to wait for the stone to pass into the distal ureter spontaneously to be treated by ESWL in situ there. Manipulating stones back into the kidney and treating them by ESWL there (pushback/ESWL) offers no advantage over ESWL in situ, as the results are similar, yet morbidity is higher. 'Blind' instrumentation and open surgery have lost all justification.
引用
收藏
页码:159 / 167
页数:9
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