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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/02/16 23:46:03」(JST)

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A nephrostomy is an artificial opening created between the kidney and the skin which allows for the urinary diversion directly from the upper part of the urinary system (renal pelvis).

An urostomy is a related procedure performed more distally along the urinary system to provide urinary diversion.

Uses

A nephrostomy is performed whenever a blockage keeps urine from passing from the kidneys, through the ureter and into the urinary bladder. Without another way for urine to drain, pressure would rise within the urinary system and the kidneys would be damaged.

The most common cause of blockage necessitating a nephrostomy is cancer, especially ovarian cancer and colon cancer. Nephrostomies may also be required to treat pyonephrosis, hydronephrosis and kidney stones.

Process

Nephrostomies are created by surgeons or interventional radiologists and typically consist of a catheter which pierces the skin and rests in the urinary tract. It is performed under ultrasound guidance, CT fluoroscopy or under image intensifier. Local anesthetic infiltration is used to numb the area where the needle would pass through to make the puncture on the kidney.

Newer technologies such as 3D fluoroscopy are being developed to aid in placement of these types of drainage tubes.^[1]

Urine is collected in an external bag which can be emptied as often as necessary.

References

^ Macaluso JN: Editorial Comment Urology March 2009 Vol. 73, Issue 3, 652-653, on Effectiveness of Three-dimensional Fluoroscopy in Percutaneous Nephrostomy: An Animal Model Study March 2009 Vol. 73, Issue 3, 649-652

External links

Cardiovascular and Interventional Radiological Society of Europe

UpToDate Contents

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1. 尿管ステントの留置およびマネージメント placement and management of indwelling ureteral stents
2. 成人における腎尿管結石症マネージメントのオプション options in the management of renal and ureteral stones in adults
3. 急性複雑性膀胱炎および腎盂腎炎 acute complicated cystitis and pyelonephritis
4. 尿路閉塞および水腎症の臨床症状および診断 clinical manifestations and diagnosis of urinary tract obstruction and hydronephrosis
5. 妊娠中の腎結石症 nephrolithiasis during pregnancy

English Journal

Factors affecting complication rates of percutaneous nephrolithotomy in children: results of a multi-institutional retrospective analysis by the Turkish pediatric urology society.

Onal B1, Dogan HS2, Satar N3, Bilen CY4, Güneş A5, Ozden E6, Ozturk A7, Demirci D8, Istanbulluoğlu O9, Gurocak S10, Nazli O11, Tanriverdi O12, Kefi A13, Korgali E14, Silay MS15, Inci K4, Izol V3, Altintas R5, Kilicarslan H2, Sarikaya S6, Yalcin V16, Aygun C9, Gevher F16, Aridogan IA3, Tekgul S4.Author information 1Department of Urology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. Electronic address: bulonal@yahoo.com.2Department of Urology, Uludag University Faculty of Medicine, Bursa, Turkey.3Department of Urology, Cukurova University Faculty of Medicine, Adana, Turkey.4Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey.5Department of Urology, Inonu University Faculty of Medicine, Malatya, Turkey.6Department of Urology, Ondokuz Mayıs University Faculty of Medicine, Samsun, Turkey.7Department of Urology, Selcuk University Faculty of Medicine, Konya, Turkey.8Department of Urology, Erciyes University Faculty of Medicine, Kayseri, Turkey.9Department of Urology, Baskent University Faculty of Medicine, Ankara and Konya, Turkey.10Department of Urology, Gazi University Faculty of Medicine, Ankara, Turkey.11Department of Urology, Ege University Faculty of Medicine, Izmir, Turkey.12Department of Urology, Sisli Etfal Education and Research Hospital, Istanbul, Turkey.13Department of Urology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.14Department of Urology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.15Department of Urology, Bezmialem Vakif University Faculty of Medicine, Istanbul, Turkey.16Department of Urology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.AbstractPURPOSE: We assessed factors affecting complication rates of percutaneous nephrolithotomy in children.
The Journal of urology.J Urol.2014 Mar;191(3):777-82. doi: 10.1016/j.juro.2013.09.061. Epub 2013 Oct 3.
PURPOSE: We assessed factors affecting complication rates of percutaneous nephrolithotomy in children.MATERIALS AND METHODS: We retrospectively evaluated data on 1,205 renal units in 1,157 children treated with percutaneous nephrolithotomy at 16 Turkish centers between 1991 and 2012. Of the patients
PMID 24095906

Kidney stones during pregnancy.

Semins MJ1, Matlaga BR2.Author information 1University of Pittsburgh Medical Center, Mercy Hospital, 1350 Locust Street, Suite G100A, Building C, Pittsburgh, PA 15219, USA.2The James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, 600 North Wolfe Street, Park 2, Baltimore, MD 21287, USA.AbstractKidney stones affect 10% of people at some point in their lives and, for some unfortunate women, this happens during pregnancy. Pregnancy is a complex state and both physiological and mechanical changes alter risk factors for kidney stone formation. When a pregnant woman develops acute nephrolithiasis, the situation is more complicated than in nonpregnant women. Imaging limitations and treatment restrictions mean that special diagnostic and management algorithms are needed upon presentation. Ultrasonography remains the gold-standard first-line diagnostic imaging modality for kidney stones during pregnancy but several second-line alternatives exist. Acute renal colic during pregnancy is associated with risks to both mother and fetus. As such, these patients need to be handled with special attention. First-line management is generally conservative (trial of passage and pain management) and is associated with a high rate of stone passage. Presentation of obstructive nephrolithiasis with associated infection represents a unique and serious clinical situation requiring immediate drainage. If infection is not present and conservative management fails, ureteroscopy can be offered if clinically appropriate, but, in some circumstances, temporary drainage with ureteral stent or nephrostomy tube might be indicated. Shockwave lithotripsy and percutaneous nephrolithotomy are contraindicated during pregnancy.
Nature reviews. Urology.Nat Rev Urol.2014 Feb 11. doi: 10.1038/nrurol.2014.17. [Epub ahead of print]
Kidney stones affect 10% of people at some point in their lives and, for some unfortunate women, this happens during pregnancy. Pregnancy is a complex state and both physiological and mechanical changes alter risk factors for kidney stone formation. When a pregnant woman develops acute nephrolithias
PMID 24515090

Urinary Diversion During and After Pediatric Pyeloplasty: A Population-Based Analysis of Over 2,000 Patients.

Sturm RM1, Chandrasekar T1, Durbin-Johnson B2, Kurzrock EA1.Author information 1Department of Urology, University of California Davis, 4860 Y Street, Sacramento, CA 95817.2Division of Biostatistics, University of California Davis, Davis, CA 95616.AbstractPURPOSE: The goal of this study was to evaluate the utilization and efficacy of intraoperative urine diversion with ureteral stent or nephrostomy tube (NT) during pediatric pyeloplasty.
The Journal of urology.J Urol.2014 Feb 8. pii: S0022-5347(14)00123-2. doi: 10.1016/j.juro.2014.01.089. [Epub ahead of print]
PURPOSE: The goal of this study was to evaluate the utilization and efficacy of intraoperative urine diversion with ureteral stent or nephrostomy tube (NT) during pediatric pyeloplasty.MATERIALS AND METHODS: The FPSC national billing database was queried to identify all pediatric pyeloplasties perfo
PMID 24518773

Japanese Journal

Tubeless PNL症例の臨床的検討

泌尿器科紀要 = Acta urologica Japonica 61(8), 313-316, 2015-08
NAID 120005656530

両側水腎症を合併した炎症性腹部大動脈瘤・両側総腸骨動脈瘤に対し腹部ステントグラフト内挿術を行った1 例

日本血管外科学会雑誌 25(0), 19-22, 2015
NAID 130005127624

A Nephrostomy-associated Urinary Tract Infection Caused by <i>Elizabethkingia meningoseptica</i>

Internal Medicine 54(24), 3233-3236, 2015
NAID 130005114249

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