Endourological combined therapy for urolithiasis：Art of TAP（TUL-assisted PNL）in the modified Valdivia position

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  • 尿路結石内視鏡手術における併用療法：修正Valdivia体位によるTAP（TUL-assisted PNL）
  • ニョウロ ケッセキ ナイシキョウ シュジュツ ニ オケル ヘイヨウ リョウホウ : シュウセイ Valdivia タイイ ニ ヨル TAP(TUL-assisted PNL)

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Abstract

  Objective：We describe our technique and experience of TAP（TUL-assisted PNL）in the modified Valdivia position. <br>  Patients and methods：From November 2007 to March 2011, 59 patients with complicated upper urinary tract stone disease were treated with TAP in the modified Valdivia position. Double continuous irrigation system was used to stretch the urinary tract, improve vision and wash out fragments. <br>  Results：All patients had only one percutaneous access tract achieved by combined ultrasonographic, fluoroscopic and endoscopic guidance. Stone-free rates were 77.6%. Blood transfusion was not administered, and fever＞38.5℃ occurred in 13.3% of patients. <br>  Conclusions：With a high success rate and a low major complication rate, TAP in the modified Valdivia position is efficient, safe without intraoperative re-positioning. We are sure that this method of intervention would be a standard and minimally invasive technique of endourological combined therapy for refractory upper urinary tract stone disease.

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