Dear editor,The first extraction of a renal calculi through a percutaneous nephrostomy(PCNL)was described in 1976 by Fernstro¨m and Johansson[1].Through the collaboration of urology and interventional radiology,s...Dear editor,The first extraction of a renal calculi through a percutaneous nephrostomy(PCNL)was described in 1976 by Fernstro¨m and Johansson[1].Through the collaboration of urology and interventional radiology,several innovations were later made to improve what we know today as PCNL[2].Ever since PCNL was introduced,the basic concepts for stone treatment with a nephroscope were the need for good visualization,a method to fragment larger stones,and a mechanical means to remove the fragments.Initially we started with a 30-French instrument to meet those goals;the concept was to have a large enough channel to remove 1 cm stone fragments.This decision was arbitrary at the time,and not evidence based.展开更多
Nephroureterectomy is currently the criterion-standard treatment for high-grade upper tract urothelial carcinoma(UTUC).Current guidelines and expert opinions propose some exceptions to this approach based on patient c...Nephroureterectomy is currently the criterion-standard treatment for high-grade upper tract urothelial carcinoma(UTUC).Current guidelines and expert opinions propose some exceptions to this approach based on patient characteristics,disease status,and function of the contralateral kidney.We present a rare case of a patient with horseshoe kidney,bilateral large nephrolithiasis,high-grade UTUC in one moiety,and relative parenchymal thinning of the contralateral side.The patient was treated with a percutaneous,minimally invasive,nephron sparing approach.The patient also had intracollecting system instillations of gemcitabine and docetaxel.Minimally invasive percutaneous resection of high-grade UTUC is a safe procedure in select cases.Current guidelines may not apply to all patients;unique scenarios with UTUC may require personalized decision-making and treatment at specialized centers.展开更多
文摘Dear editor,The first extraction of a renal calculi through a percutaneous nephrostomy(PCNL)was described in 1976 by Fernstro¨m and Johansson[1].Through the collaboration of urology and interventional radiology,several innovations were later made to improve what we know today as PCNL[2].Ever since PCNL was introduced,the basic concepts for stone treatment with a nephroscope were the need for good visualization,a method to fragment larger stones,and a mechanical means to remove the fragments.Initially we started with a 30-French instrument to meet those goals;the concept was to have a large enough channel to remove 1 cm stone fragments.This decision was arbitrary at the time,and not evidence based.
文摘Nephroureterectomy is currently the criterion-standard treatment for high-grade upper tract urothelial carcinoma(UTUC).Current guidelines and expert opinions propose some exceptions to this approach based on patient characteristics,disease status,and function of the contralateral kidney.We present a rare case of a patient with horseshoe kidney,bilateral large nephrolithiasis,high-grade UTUC in one moiety,and relative parenchymal thinning of the contralateral side.The patient was treated with a percutaneous,minimally invasive,nephron sparing approach.The patient also had intracollecting system instillations of gemcitabine and docetaxel.Minimally invasive percutaneous resection of high-grade UTUC is a safe procedure in select cases.Current guidelines may not apply to all patients;unique scenarios with UTUC may require personalized decision-making and treatment at specialized centers.
