PDF(Pubmed)
Abstract：
UNASSIGNED: This narrative review aims to describe measures to minimise the risk of complications during percutaneous nephrolithotomy (PCNL), ureteroscopy, and retrograde intrarenal surgery.
UNASSIGNED: A literature search was conducted from the PubMed/PMC database for papers published within the last 10 years (January 2012 to December 2022). Search terms included \"ureteroscopy\", \"retrograde intrarenal surgery\", \"PCNL\", \"percutaneous nephrolithotomy\", \"complications\", \"sepsis\", \"infection\", \"bleed\", \"haemorrhage\", and \"hemorrhage\". Key papers were identified and included meta-analyses, systematic reviews, guidelines, and primary research. The references of these papers were searched to identify any further relevant papers not included above.
UNASSIGNED: The evidence is assimilated with the opinions of the authors to provide recommendations. Best practice pathways for patient care in the pre-operative, intra-operative, and post-operative periods are described, including the identification and management of residual stones. Key complications (sepsis and stent issues) that are relevant for any endourological procedure are then be discussed. Operation-specific considerations are then explored. Key measures for PCNL include optimising access to minimise the chance of bleeding or visceral injury. The role of endoscopic combined intrarenal surgery in this regard is discussed. Key measures for ureteroscopy and retrograde intrarenal surgery include planning and technique to minimise the risk of ureteric injury. The role of anaesthetic assessment is discussed. The importance of specific comorbidities on each step of the pathway is highlighted as examples.
UNASSIGNED: This review demonstrates that the principles of meticulous planning, interdisciplinary teamworking, and good operative technique can minimise the risk of complications in endourology.
UNASSIGNED: A literature search was conducted from the PubMed/PMC database for papers published within the last 10 years (January 2012 to December 2022). Search terms included \"ureteroscopy\", \"retrograde intrarenal surgery\", \"PCNL\", \"percutaneous nephrolithotomy\", \"complications\", \"sepsis\", \"infection\", \"bleed\", \"haemorrhage\", and \"hemorrhage\". Key papers were identified and included meta-analyses, systematic reviews, guidelines, and primary research. The references of these papers were searched to identify any further relevant papers not included above.
UNASSIGNED: The evidence is assimilated with the opinions of the authors to provide recommendations. Best practice pathways for patient care in the pre-operative, intra-operative, and post-operative periods are described, including the identification and management of residual stones. Key complications (sepsis and stent issues) that are relevant for any endourological procedure are then be discussed. Operation-specific considerations are then explored. Key measures for PCNL include optimising access to minimise the chance of bleeding or visceral injury. The role of endoscopic combined intrarenal surgery in this regard is discussed. Key measures for ureteroscopy and retrograde intrarenal surgery include planning and technique to minimise the risk of ureteric injury. The role of anaesthetic assessment is discussed. The importance of specific comorbidities on each step of the pathway is highlighted as examples.
UNASSIGNED: This review demonstrates that the principles of meticulous planning, interdisciplinary teamworking, and good operative technique can minimise the risk of complications in endourology.
摘要：
■这篇叙述性综述旨在描述将经皮肾镜取石术（PCNL）中的并发症风险降至最低的措施，输尿管镜检查,和逆行肾内手术.
■从PubMed/PMC数据库中对过去10年（2012年1月至2022年12月）发表的论文进行了文献检索。搜索词包括“输尿管镜检查”，“逆行肾内手术”，\"PCNL\",“经皮肾镜取石术”，“并发症”，“败血症”，\"感染\",\"出血\",“出血”，和“出血”。确定了关键论文，并包括荟萃分析，系统评价,指导方针,和初级研究。搜索这些论文的参考文献以识别上文未包括的任何其他相关论文。
■将证据与作者的意见同化，以提供建议。术前患者护理的最佳实践路径，术中,并描述了术后时期，包括残余结石的识别和管理。然后讨论与任何腔内手术相关的关键并发症（败血症和支架问题）。然后探索特定操作的考虑。PCNL的关键措施包括优化通路，以最大限度地减少出血或内脏损伤的机会。讨论了内窥镜联合肾内手术在这方面的作用。输尿管镜检查和逆行肾内手术的关键措施包括计划和技术，以最大程度地减少输尿管损伤的风险。讨论了麻醉评估的作用。作为示例，强调了途径每个步骤中特定合并症的重要性。
■这篇综述表明，精心策划的原则，跨学科团队合作，良好的手术技术可以最大程度地减少腔内泌尿外科并发症的风险。
■从PubMed/PMC数据库中对过去10年（2012年1月至2022年12月）发表的论文进行了文献检索。搜索词包括“输尿管镜检查”，“逆行肾内手术”，\"PCNL\",“经皮肾镜取石术”，“并发症”，“败血症”，\"感染\",\"出血\",“出血”，和“出血”。确定了关键论文，并包括荟萃分析，系统评价,指导方针,和初级研究。搜索这些论文的参考文献以识别上文未包括的任何其他相关论文。
■将证据与作者的意见同化，以提供建议。术前患者护理的最佳实践路径，术中,并描述了术后时期，包括残余结石的识别和管理。然后讨论与任何腔内手术相关的关键并发症（败血症和支架问题）。然后探索特定操作的考虑。PCNL的关键措施包括优化通路，以最大限度地减少出血或内脏损伤的机会。讨论了内窥镜联合肾内手术在这方面的作用。输尿管镜检查和逆行肾内手术的关键措施包括计划和技术，以最大程度地减少输尿管损伤的风险。讨论了麻醉评估的作用。作为示例，强调了途径每个步骤中特定合并症的重要性。
■这篇综述表明，精心策划的原则，跨学科团队合作，良好的手术技术可以最大程度地减少腔内泌尿外科并发症的风险。
