Lin D W, Bush W H, Mayo M E
Department of Urology, University of Washington, Seattle, USA.
J Urol. 1999 Sep;162(3 Pt 1):696-8. doi: 10.1097/00005392-199909010-00017.
The Acucise endoureterotomy balloon catheter has proved to be a safe and effective alternative to open surgery for the management of ureteropelvic junction obstruction and benign ureteral stricture disease. The established management of ureteroenteric strictures following urinary diversion is open surgical revision. There are few reports evaluating the efficacy of Acucise endoureterotomy in patients with ureteroenteric strictures.
The Acucise cutting balloon catheter was used to treat 9 patients with 12 ureteroenteric strictures 2 cm. or less in length. Median time from diversion to stricture was 48 months (range 13 to 192). Success was defined as resolution of symptoms and radiographic confirmation of patency.
Recurrence of malignancy accounted for failure in 1 patient with bilateral strictures. Of the remaining 10 benign strictures 7 (70%) required open revision or serial stent changes. The remaining 3 strictures in 2 patients have remained patent at 30 and 18 months of followup for a success rate of 30%. There were no perioperative or operative complications. Mean followup was 9 months after Acucise treatment before intervention was necessary.
Acucise endoureterotomy for ureteroenteric strictures following urinary diversion is a low morbidity procedure. Although the success rate is only 30%, Acucise endoureterotomy offers an alternative to immediate open surgical revision.
对于肾盂输尿管连接部梗阻和良性输尿管狭窄疾病的治疗，Acucise 腔内输尿管切开球囊导管已被证明是一种安全有效的开放性手术替代方法。尿流改道术后输尿管肠吻合口狭窄的既定治疗方法是开放性手术修复。很少有报告评估 Acucise 腔内输尿管切开术治疗输尿管肠吻合口狭窄患者的疗效。
使用 Acucise 切割球囊导管治疗 9 例患者的 12 处长度为 2 cm 或更短的输尿管肠吻合口狭窄。从尿流改道至狭窄的中位时间为 48 个月（范围 13 至 192 个月）。成功定义为症状缓解及通过影像学检查确认通畅。
1 例双侧狭窄患者因恶性肿瘤复发导致治疗失败。其余 10 处良性狭窄中，7 处（70%）需要进行开放性修复或序贯更换支架。2 例患者的其余 3 处狭窄在随访 30 个月和 18 个月时仍保持通畅，成功率为 30%。无围手术期或手术并发症。在需要进行干预之前，Acucise 治疗后的平均随访时间为 9 个月。
尿流改道术后输尿管肠吻合口狭窄的 Acucise 腔内输尿管切开术是一种低发病率的手术。尽管成功率仅为 30%，但 Acucise 腔内输尿管切开术为立即进行开放性手术修复提供了一种替代方法。
