Faerber G J, Richardson T D, Farah N, Ohl D A
Department of Surgery, University of Michigan Medical Center, Ann Arbor, USA.
J Urol. 1997 Feb;157(2):454-8.
We assessed the efficacy and safety of a new cutting balloon catheter to treat symptomatic ureteropelvic junction obstruction in adults.
A total of 32 adults (mean age 40 years, range 18 to 79) underwent retrograde balloon incision for symptomatic ureteropelvic junction obstruction (27 primary and 5 secondary cases). Treatment outcome was based on improvement of symptoms and resolution of obstruction by excretory urography or diuretic renal scintigraphy.
A total of 36 retrograde endopyelotomies was performed on 32 patients. Of 4 patients who underwent repeat endopyelotomy 2 had resolution of persistent obstruction. At a mean followup of 14 months (range 3 to 28) 28 of 32 patients (87.5%) were rendered symptom-free and had no obstruction on excretory urography or diuretic renography. Average hospital stay was 1.8 days (range 0 to 6) and the complication rate was 15.6% (postoperative bleeding, fever and ileus). Treatment failed in 4 patients and subsequent open pyeloplasty was successful.
Retrograde balloon incision endopyelotomy appears to be a safe and effective treatment for ureteropelvic junction obstruction.
我们评估了一种新型切割球囊导管治疗成人有症状的输尿管肾盂连接部梗阻的疗效和安全性。
共有32例成人（平均年龄40岁，范围18至79岁）因有症状的输尿管肾盂连接部梗阻接受了逆行球囊切开术（27例原发性和5例继发性病例）。治疗结果基于症状的改善以及排泄性尿路造影或利尿肾闪烁扫描显示梗阻的解除。
对32例患者共进行了36次逆行肾盂内切开术。在4例接受重复肾盂内切开术的患者中，2例持续性梗阻得到解除。平均随访14个月（范围3至28个月），32例患者中有28例（87.5%）症状消失，排泄性尿路造影或利尿肾图检查未显示梗阻。平均住院时间为1.8天（范围0至6天），并发症发生率为15.6%（术后出血、发热和肠梗阻）。4例患者治疗失败，随后的开放性肾盂成形术成功。
逆行球囊切开肾盂内切开术似乎是治疗输尿管肾盂连接部梗阻的一种安全有效的方法。
