肾盂输尿管连接部二级梗阻的处理——肾盂成形术与内切开术的比较。
The management of secondary pelvi-ureteric junction obstruction - a comparison of pyeloplasty and endopyelotomy.
机构信息
The Bristol Urological Institute, Southmead Hospital, North Bristol NHS Trust, Bristol, Gloucestershire, UK.
出版信息
BJU Int. 2014 Jan;113(1):108-12. doi: 10.1111/bju.12454.
OBJECTIVE
To review our experience in the management of secondary pelvi-ureteric junction obstruction (PUJO) comparing endopyelotomy with pyeloplasty.
PATIENTS AND METHODS
We retrospectively analysed our database of 58 patients having undergone operative management of PUJO after failed primary management, including 41 with failed pyeloplasty and 17 failed endopyelotomy. Outcomes included mercapto-acetyltriglycine (MAG3) drainage capacity, symptomatic control and need for further intervention. Success was defined as freedom from failure in all three.
RESULTS
Patients undergoing secondary pyeloplasty had better outcomes than endopyelotomy for symptomatic success (87.5% vs 74%), resolution of obstruction on MAG3 renography (96% vs 74%), and no need for further intervention (96% vs 71%). Overall success was 87.5% for pyeloplasty compared with 44% after secondary endopyelotomy.
CONCLUSION
Outcomes of pyelopasty for secondary PUJO were superior when compared with endopyelotomy.
目的
回顾我们在处理继发性肾盂输尿管连接部梗阻（PUJO）方面的经验，比较经皮肾镜肾盂成形术和内切开术的效果。
患者和方法
我们回顾性分析了数据库中 58 例接受手术治疗的继发性 PUJO 患者的资料，其中 41 例曾行失败的肾盂成形术，17 例曾行失败的内切开术。结果包括巯基乙酰三甘氨酸（MAG3）引流能力、症状控制和进一步干预的需要。成功定义为所有三个方面均无失败。
结果
对于症状成功（87.5%对 74%）、MAG3 肾图上梗阻的解决（96%对 74%）和无需进一步干预（96%对 71%），行继发性肾盂成形术的患者的结果优于内切开术。肾盂成形术的总体成功率为 87.5%，而继发性内切开术的成功率为 44%。
结论
与内切开术相比，肾盂成形术治疗继发性 PUJO 的效果更好。
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