Lin C-M, Tsai T-H, Lin T-C, Tang S-H, Wu S-T, Sun G-H, Cha T-L
Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defence Medical Centre, Taipei, Taiwan, Republic of China.
Acta Chir Belg. 2009 Nov-Dec;109(6):746-50. doi: 10.1080/00015458.2009.11680528.
This study aimed to report the results of endoureterotomy for benign ureteral strictures using the holmium: yttrium-aluminum-garnet laser.
Nineteen patients (8 men and 11 women, mean age 51.47 years) underwent holmium: yttrium-aluminum-garnet laser endoureterotomy for benign ureteral strictures (8 proximal, 3 middle, and 8 distal) using semi-rigid ureteroscopy and 360-microm fibre at 1.2 J/pulse and 10 Hz. After completion of the incision, a 7-Fr double-J ureteral stent was left for 6 weeks. Thereafter, the patients were followed-up by ultrasound and/or intravenous urography at 3-6 monthly intervals.
Success was defined as the absence of symptoms plus radiographic resolution of obstructions as assessed by diuretic renography and/or intravenous urography. With a mean follow-up of 40.2 months, success was achieved in 10 (52.6%) of the 19 patients. Nine patients developed recurrent strictures and were considered treatment failures. The stricture length and severity of hydronephrosis correlated with successful outcome, but gender, aetiology, side and location of strictures did not predict outcome.
Although endoureterotomy using a holmium : yttrium-aluminum-garnet laser has an equivocal outcome, the procedure is recommended as a safe, less invasive therapeutic option for the initial management of benign ureteral strictures.
本研究旨在报告使用钬：钇铝石榴石激光进行良性输尿管狭窄内切开术的结果。
19例患者（8例男性和11例女性，平均年龄51.47岁）因良性输尿管狭窄（8例近端、3例中段和8例远端）接受钬：钇铝石榴石激光输尿管内切开术，采用半硬性输尿管镜和360微米光纤，能量为1.2焦耳/脉冲，频率为10赫兹。切开完成后，留置一根7F双J输尿管支架6周。此后，每隔3至6个月通过超声和/或静脉肾盂造影对患者进行随访。
成功定义为无症状且通过利尿肾图和/或静脉肾盂造影评估梗阻在影像学上得到缓解。平均随访40.2个月，19例患者中有10例（52.6%）取得成功。9例患者出现复发性狭窄，被视为治疗失败。狭窄长度和肾积水严重程度与成功结果相关，但性别、病因、狭窄侧别和位置不能预测结果。
尽管使用钬：钇铝石榴石激光进行输尿管内切开术的结果不明确，但该手术被推荐作为良性输尿管狭窄初始治疗的一种安全、侵入性较小的治疗选择。
