Post Date December, 02 2023
"Sandwich" therapy is a new technique for intracavitary urology that systematically treats large, multi branched, or complex stones. Suitable for patients who cannot be used alone: ESWL or percutaneous nephrolithotomy. The goal is to minimize the risk of bleeding and sepsis, reduce the frequency of shock waves, and reduce dependence on long-term nephrostomy and drainage. Using this method for percutaneous lithotomy requires only one or two percutaneous renal channels. Stones that are difficult to reach through the percutaneous renal channel are subsequently treated with ESWL lithotripsy. Compared to percutaneous lithotomy alone, this method reduces the number of percutaneous renal channels, thereby reducing the risk of bleeding, perforation, urinary extravasation, and sepsis. "Sandwich" therapy involves using percutaneous techniques to remove some stones, then using ESWL to crush stones or stone fragments that extend inside the renal calices that are difficult to reach through percutaneous approaches, followed by percutaneous stone removal. Within a reasonable time frame, percutaneous stone removal or ESWL can be performed again. The specific technical operations are as follows.
The selection of the puncture point for the first percutaneous nephrostomy should be based on the principle of being closest to the largest part of the kidney stone. For more complex stones, the first percutaneous lithotomy often requires 2 to 3 or even more channels. After the first percutaneous lithotomy, a 24F catheter was retained for drainage.
renal calculus
