Feng C C, Dong G, Hang Z, Jiang H, Ding Q, Zhang Y, Wu Z
Department of Urology, Huashan Hospital, Fudan University, 12 Central Urumqi Rd, Shanghai, PR China -
Minerva Urol Nefrol. 2015 Oct 16.
To assess efficacy of laser endopyelotomy in both primary and secondary ureteropelvic junction obstructions (UPJOs) PATIENTS AND METHODS: Primary category consisted of 10 patients of congenital UPJOs. Secondary category was comprised of UPJOs in 12 status post pyeloplasty, 10 status post lithotomy, 5 status post shock wave lithotripsy, and 10 status post ureteroscopic lithotripsy. Ho:YAG laser endopyelotomy was performed in all subjects. Exclusion criteria included obstructions longer than 2 cm, ipsilateral upper urinary calculi and crossing vasculature.
Mean operation time was 44 min. Average inpatient duration was 1.87 days. No major complication occurred. Follow-ups were at least 12 months. Success rate for single endopyelotomy was 82.5%, leaving 7 patients for a secondary endopyelotomy. Secondary UPJO due to failed pyeloplasty had a predilection of restenosis after endopyelotomy (P = 0.0005) compared to other aetiologies.
Ho:YAG laser endopyelotomy is a safe and effective approach effective in both primary and secondary UPJO treatments.
评估激光肾盂内切开术治疗原发性和继发性输尿管肾盂连接部梗阻（UPJO）的疗效。
原发性组包括10例先天性UPJO患者。继发性组包括肾盂成形术后12例、取石术后10例、冲击波碎石术后5例以及输尿管镜碎石术后10例的UPJO患者。所有受试者均接受钬激光肾盂内切开术。排除标准包括梗阻长度超过2cm、同侧上尿路结石以及交叉血管。
平均手术时间为44分钟。平均住院时间为1.87天。未发生重大并发症。随访时间至少12个月。单次肾盂内切开术的成功率为82.5%，7例患者需进行二次肾盂内切开术。与其他病因相比，肾盂成形术失败导致的继发性UPJO在肾盂内切开术后更容易发生再狭窄（P = 0.0005）。
钬激光肾盂内切开术是一种安全有效的方法，对原发性和继发性UPJO治疗均有效。
