Nephrostomy

Renal ostomy is a method of high-grade urinary diversion, which has important applications in urology. Renal ostomy itself is a separate procedure and is sometimes used after other kidney procedures such as pyeloplasty. Renal ostomy is an urgent measure during empyema. At present, due to the development of urological endoscopic techniques, nephrostomy is developed by resolving renal pelvic drainage to percutaneous nephrostomy, taking stones, and draining through the renal stoma, which can be used for angiography in the treatment of extracorporeal shock wave lithotripsy. The location of the stone, and the indwelling nephrostomy tube can make the broken stone easy to be excreted after ESWL treatment, avoiding the stone to block the ureter, and can be treated with percutaneous nephrostomy, which becomes an auxiliary means in the treatment of stones. Treatment of diseases: renal insufficiency Indication Renal ostomy can be divided into permanent renal stoma and temporary renal stoma according to the time and purpose of ostomy tube indwelling. Temporary renal stoma is often used clinically. Temporary renal stoma is often completed after surgery for kidney and renal pelvis to improve renal drainage and improve the success rate of surgery. It can also be used to correct hydronephrosis or infection to improve renal function and general condition of the patient. For complex surgeons, this transitional treatment can create conditions for definitive treatment. Permanent renal stoma is a kind of palliative operation. For example, if the ureter is unable to be removed due to tumor obstruction, radioactive injury causes extensive ureteral stricture and other ureteral lesions, and lose its function, permanent renal ostomy should be performed. Surgical procedure Renal ostomy can be divided into percutaneous nephrolithotomy according to the surgical procedure; orthotopic nephrostomy exposed through the lumbar, non-free kidney, and free nephrostomy. Renal puncture stoma damage is small, the method is relatively simple, but its drainage effect is affected by the inability to ensure the proper position of the stoma tube. Inadvertent operation may cause damage to the renal blood vessels and pleura. Renal puncture ostomy is only suitable for cases with thin renal cortex and severe water accumulation. In situ nephrostomy is performed under direct vision, and the damage is not large. It can be done under local anesthesia. It is a common method for simple renal stoma. Free nephrostomy is often done after other operations in the upper urinary tract.

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