Shiozaki Keito, Izaki Hirofumi, Fukuta Kyotaro, Fukawa Tomoya, Takahashi Masayuki, Kanayama Hiroomi
Department of Urology, Tokushima Prefectural Central Hospital, 1-10-3 Kuramoto, Tokushima, 770-8539, Japan.
Department of Urology, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, 770-8503, Japan.
Urol Case Rep. 2022 Feb 16;42:102036. doi: 10.1016/j.eucr.2022.102036. eCollection 2022 May.
Ureteral stricture and obstruction following ureteroscopy are often difficult to treat. We report successful laser endoureterotomy using the cut-to-the-light technique for complete obstruction. A 44-year-old man developed complete ureteral obstruction at the ureteropelvic junction following transurethral ureterolithotripsy. We performed laser endoureterotomy and recovered the remaining stone by an antegrade percutaneous approach, while a second surgeon illuminated the obstruction with a ureteroscope by a retrograde approach. The minimally invasive cut-to-the-light technique might be an effective alternative to conventional invasive treatments, such as pyeloplasty, ureteroureterostomy and bowel interposition, in patients with complete ureteral obstruction in whom a ureteral stent cannot be placed.
输尿管镜检查后出现的输尿管狭窄和梗阻通常难以治疗。我们报告了使用“切向光”技术成功进行激光输尿管内切开术治疗完全性梗阻的病例。一名44岁男性在经尿道输尿管碎石术后，在输尿管肾盂连接处出现完全性输尿管梗阻。我们进行了激光输尿管内切开术，并通过顺行经皮途径取出了残留结石，同时另一位外科医生通过逆行途径用输尿管镜照亮梗阻部位。对于无法放置输尿管支架的完全性输尿管梗阻患者，微创的“切向光”技术可能是传统侵入性治疗（如肾盂成形术、输尿管输尿管吻合术和肠代输尿管术）的有效替代方法。
