腎造口術(nephrostomy)和尿道造口術(urostomy)的區別

在分析腎造口術和尿路造口術的區別之前，讓我們先看看“造口”一詞的含義。氣孔是連接體腔和外部環境的一個開口，無論是自然的還是外科的。腎造口術是在腎臟和背部皮膚之間人工**的一個開口，它允許直接從泌尿系統上部（腎盂）分流（尿液通過正常的輸尿管通道流動）。尿路吻合術是一種類似的手術，沿著泌尿系統（通常是從膀胱）遠端進行，以提供尿路分流。在膀胱和尿道無法排出尿液的情況下，例如在梗阻的情況下，可以進行尿路吻合術，用於尿流改道。腎造瘻和尿路吻合術的關鍵區別在於，腎造瘻術是在腎盂和背部皮膚之間進行的，而造瘻術是在膀胱/輸尿管下段和下腹部皮膚之間進行的。然而，尿路造口術有時指的是尿路與外部的任何連接，包括腎造口。

什麼是腎造口術(nephrostomy)？

Nephrostomy is an artificial connection between the upper part of the urinary tract and the skin on the back created surgically to facilitate the flow of urine in the presence of a distal obstruction to the urinary tract. Generally, a hole is created under anesthesia using surgical instruments. Then the hole is enlarged using dilators. This is done under ultrasonic guidance. Then a pigtail catheter is inserted between the renal pelvis and the exterior. This will allow free flow of urine by passing a distal obstruction. The external end of the catheter is usually connected to a collecting bag. This procedure is done in the case of urinary stone disease, which causes complete obstruction or renal abscess, a malignancy causing ureteric obstructi***. This procedure helps to protect the remaining renal tissue from further damage. This is usually done as an emergency procedure. Once the distal obstruction is relieved, the nephrostomy can be removed. Common complicati*** of the procedure are accidental renal puncture causing lot of bleeding, rupture of the renal pelvis and the displacement and blockage of the pigtail catheter. Patency of the catheter can be tested by a die test which is usual in the case of obstructi***.

什麼是尿道造口術(urostomy)？

Urostomy is usually created between the urinary bladder or lower ureters and the skin on the lower abdomen. This procedure is quite different, and the ureters are directly opened to the outside or part of the bowel is used to create the stoma. Then the stoma is covered with a collecting bag. Sometimes an internal pouch is surgically created to collect urine using a part of the bowel when the bladder is removed during the surgery such as in bladder carcinoma. This procedure is done in situati*** like infiltrating prostatic or bladder carcinoma, urethral injury. Complicati*** of the procedure include bladder injury and cystitis.

腎造口術(nephrostomy)和尿道造口術(urostomy)的區別

腎造瘻和尿路造瘻的特點：

解剖：

腎造口術：腎造口術是在腎盂和背部皮膚之間形成的。

尿路吻合術：在膀胱/輸尿管下段和下腹部皮膚之間造瘻。

使用的導管：

腎造口術：豬尾管用於尿路引流。

尿路吻合術：輸尿管遠端或腸的一部分與皮膚縫合形成造口。

難題：

腎造口術：腎造口術會導致意外的腎穿刺出血、腎盂破裂、豬尾管移位堵塞。

尿道吻合術：尿道吻合術會導致內臟**損傷和感染、*****和皮膚相關併發症，如瘙癢。

目的：

腎造口術：腎造口術是為了緩解上尿路梗阻，如結石引起的完全梗阻或腎膿腫，惡性腫瘤引起的尿路梗阻。