Bagley D H, Liu J B, Goldberg B B, Grasso M
Department of Urology, Thomas Jefferson University, Philadelphia, PA, USA.
J Endourol. 1995 Dec;9(6):465-7. doi: 10.1089/end.1995.9.465.
Endoscopic incision has become a common treatment for ureteropelvic junction (UPJ) obstruction. Recent reports have indicated the importance of crossing vessels in the success of endopyelotomy. Endoluminal ultrasound can define the location and size of adjacent vessels, and the effect of these vessels and their location on the success of endopyelotomy can be determined. A group of 28 patients found to have UPJ obstruction on excretory urography, retrograde ureteropyelography, radiographic nuclear scan, and clinical presentation were evaluated by endoluminal ultrasound at the time of endopyelotomy, which was performed by percutaneous nephroscopy or retrograde ureteroscopy. All patients had an indwelling ureteral stent postoperatively. Follow-up evaluation included renal ultrasound and nuclear scans. Excretory urography was performed in several patients. In this preliminary study, the success rate was lower in patients with vessels in a lateral position at the UPJ. The endoscopic approach did not alter the success rate. These factors should be considered in treating primary UPJ obstruction with endoluminal incision.
内镜下切开术已成为治疗肾盂输尿管连接处（UPJ）梗阻的常用方法。近期报告表明，交叉血管对于肾盂内切开术的成功至关重要。腔内超声能够确定相邻血管的位置和大小，并且可以确定这些血管及其位置对肾盂内切开术成功的影响。一组28例经排泄性尿路造影、逆行输尿管肾盂造影、放射性核素扫描及临床表现确诊为UPJ梗阻的患者，在经皮肾镜或逆行输尿管镜进行肾盂内切开术时接受了腔内超声评估。所有患者术后均留置输尿管支架。随访评估包括肾脏超声和核素扫描。部分患者进行了排泄性尿路造影。在这项初步研究中，UPJ处血管位于外侧的患者成功率较低。内镜治疗方法并未改变成功率。在用腔内切开术治疗原发性UPJ梗阻时应考虑这些因素。
