婴幼儿开放性肾盂成形术失败后的经皮肾盂内切开术
Percutaneous endopyelotomy in infants and young children after failed open pyeloplasty.
作者信息
Faerber G J, Ritchey M L, Bloom D A
机构信息
Department of Surgery, University of Michigan School of Medicine, Ann Arbor, USA.
出版信息
J Urol. 1995 Oct;154(4):1495-7.
PURPOSE
We assessed the efficacy and safety of percutaneous endopyelotomy in infants and young children with secondary ureteropelvic junction obstruction after previous open pyeloplasty.
MATERIALS AND METHODS
Three boys and 2 girls with persistent ureteropelvic junction obstruction after open pyeloplasty underwent percutaneous antegrade cold knife endopyelotomy via an 18F nephrostomy tract.
RESULTS
Percutaneous endopyelotomy was successfully performed in all 5 children with minimal complications. At a mean followup of 2.5 years endopyelotomy was successful in 4 of the 5 children based on the absence of symptoms, normal pressure-perfusion studies and normal or improved diuretic renal scintigraphy studies. One child in whom endopyelotomy failed underwent successful ureterocalicostomy.
CONCLUSIONS
Percutaneous antegrade endopyelotomy is a safe and efficacious method of treating secondary ureteropelvic junction obstruction in children. This method offers a minimally invasive alternative to conventional repeat open pyeloplasty.
目的
我们评估了经皮肾盂内切开术对既往开放性肾盂成形术后继发输尿管肾盂连接处梗阻的婴幼儿的疗效及安全性。
材料与方法
3名男孩和2名女孩在开放性肾盂成形术后存在持续性输尿管肾盂连接处梗阻，经18F肾造瘘通道接受了经皮顺行冷刀肾盂内切开术。
结果
所有5名儿童均成功进行了经皮肾盂内切开术，并发症极少。平均随访2.5年时，基于无症状、压力灌注研究正常以及利尿肾动态显像研究正常或改善，5名儿童中有4名肾盂内切开术成功。肾盂内切开术失败的1名儿童接受了成功的输尿管肾盂造口术。
结论
经皮顺行肾盂内切开术是治疗儿童继发性输尿管肾盂连接处梗阻的一种安全有效的方法。该方法为传统的再次开放性肾盂成形术提供了一种微创替代方案。
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