Lojanapiwat Bannakij, Soonthonpun Surithorn, Wudhikarn Supot
Division of Urology, Department of Surgery, Chiangmai University, Chiangmai, Thailand 50200.
Asian J Surg. 2002 Apr;25(2):130-3. doi: 10.1016/S1015-9584(09)60160-3.
The traditional choice of procedure for treatment of ureteral stricture is open surgical repair. Advances in endourology have provided the urological surgeon with an alternative to open surgery for the treatment of benign ureteral stricture.
Twenty-seven benign ureteral strictures in 24 patients were treated by the endourological method. Twelve endoureterotomies were performed using a cold knife via a 9.5Fr Storz ureteroscope and 15 high pressure balloon dilations were performed. The ureters were stented with 7 Fr double-J stents for 6 weeks.
The success rate was 9/12 (75%) in the endoureterotomy group and 9/15 (60%) in the balloon dilation group after follow-up for more than 6 months.
Endoscopic treatment of ureteral strictures appeared to be a safe and reasonably effective modality for the treatment of ureteral strictures, especially for the short type that are non-ischaemic in origin and not associated with radiation therapy. Endourological treatment of ureteral strictures is the procedure of choice for initial management of benign ureteral strictures and has high success rates and fewer complications.
治疗输尿管狭窄的传统手术选择是开放性手术修复。腔内泌尿外科技术的进步为泌尿外科医生提供了一种替代开放性手术治疗良性输尿管狭窄的方法。
对24例患者的27处良性输尿管狭窄采用腔内泌尿外科方法进行治疗。通过9.5Fr的Storz输尿管镜用冷刀进行了12次输尿管内切开术，并进行了15次高压球囊扩张。输尿管用7Fr双J支架置入6周。
随访超过6个月后，输尿管内切开术组成功率为9/12（75%），球囊扩张组成功率为9/15（60%）。
输尿管狭窄的内镜治疗似乎是治疗输尿管狭窄的一种安全且相当有效的方式，特别是对于起源非缺血且与放射治疗无关的短段型狭窄。输尿管狭窄的腔内泌尿外科治疗是良性输尿管狭窄初始治疗的首选方法，成功率高且并发症少。
