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钬激光输尿管内切开术治疗良性输尿管狭窄的长期疗效

Long-term efficacy of holmium laser endoureterotomy for benign ureteral strictures.

作者信息

Lane Brian R, Desai Mihir M, Hegarty Nicholas J, Streem Stevan B

机构信息

Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

出版信息

Urology. 2006 May;67(5):894-7. doi: 10.1016/j.urology.2005.11.012.

DOI:10.1016/j.urology.2005.11.012
PMID:16698348
Abstract

OBJECTIVES

To determine the long-term clinical and radiographic success of holmium laser endoureterotomy for nonobliterative benign ureteral strictures.

METHODS

A total of 19 patients (12 women and 7 men, mean age 47.5 years) underwent holmium laser endoureterotomy for iatrogenic ureteral strictures (seven proximal, seven mid, and five distal) using semirigid ureteroscopy and a 360-microm fiber at 1 J and 10 Hz.

RESULTS

Success was strictly defined as both relief of symptoms and radiographic resolution of obstruction by intravenous pyelography or diuretic renography, or both. With a median follow-up of 3.0 years, success was achieved in 13 (68.4%) of 19 patients.

CONCLUSIONS

Our results have shown that holmium laser endoureterotomy is associated with a long-term success rate equivalent to, or better than, other currently available minimally invasive treatment options. Also, failure was uniformly evident within the first 3 months after treatment.

摘要

目的

确定钬激光输尿管内切开术治疗非闭塞性良性输尿管狭窄的长期临床及影像学成功率。

方法

共有19例患者(12例女性,7例男性,平均年龄47.5岁)因医源性输尿管狭窄(7例近端、7例中段和5例远端)接受钬激光输尿管内切开术,采用半硬性输尿管镜及一根360微米光纤,能量为1焦耳,频率为10赫兹。

结果

成功被严格定义为症状缓解且通过静脉肾盂造影或利尿肾图检查显示梗阻在影像学上得到解决,或两者皆满足。中位随访时间为3.0年,19例患者中有13例(68.4%)取得成功。

结论

我们的结果表明,钬激光输尿管内切开术的长期成功率与其他目前可用的微创治疗方案相当,或优于这些方案。此外,治疗后最初3个月内失败情况均很明显。

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