摘要
经皮肾镜取石术(PCNL)被广泛应用于治疗肾和输尿管上段结石。经过40余年的发展,PCNL手术体位从最初的俯卧位逐步发展为俯卧位、仰卧位和侧卧位三种体位。在这三种体位下实施PCNL都是安全有效的,它们各具优势,也有不足。为了适应复杂病例的手术需求,每种体位都经历改良而衍生出多种改良体位,改良后的体位或改善了术中操作的空间,或便于同时进行PCNL操作和逆行尿路内镜操作等,都不同程度地提高了手术效率和安全性,改善了患者的舒适度,扩大其适应证,最终促进了PCNL的发展。充分认识各种PCNL手术体位的优势和不足,才能为患者选择恰当的手术体位,为进一步改进PCNL手术体位提供依据。
Percutaneous Nephrolithotomy(PCNL)is widely used in the treatment of renal calculi and upper ureteral calculi worldwide.After more than 40 years of development,modern-day PCNL has transformed from an operation traditionally undertaken in the prone position to a procedure in which a prone,supine or lateral position may be employed.PCNL is safe and effective in these 3 surgical positions,with their respective advantages and disadvantages.In order to adapt to the complex cases,each position has undergone multiple modifications resulting in multiple modified positions.These modified positions improve the operating space of the mirror,or facilitate simultaneously PCNL and retrograde urinary tract endoscopy operation,and so on,and then the efficiency and safety of surgery and the patient’s comfort are improved to varying degrees,the indications are expanded,eventually the development of PCNL is promoted.Only by fully understanding the advantages and disadvantages of various PCNL surgical positions can we choose the appropriate surgical positions for patients and provide the basis for further improvement of PCNL position.
作者
张剑歌
周立权(审校)
ZHANG Jiange;ZHOU Liquan(Center of Genomic and Personalized Medicine of Guangxi Medical University,Nanning 530021,China;Department of Urology,the Second Affiliated Hospital of Guangxi Medical University)
出处
《微创泌尿外科杂志》
2021年第3期202-209,共8页
Journal of Minimally Invasive Urology
关键词
经皮肾镜取石术
手术体位
肾结石
percutaneous nephrolithotomy
surgical position
renal calculi
