小儿肾盂输尿管连接部梗阻的经皮肾盂内切开术与开放性肾盂成形术的比较。
Comparison of percutaneous endopyelotomy with open pyeloplasty for pediatric ureteropelvic junction obstruction.
作者信息
Schenkman E M, Tarry W F
机构信息
Department of Urology, West Virginia University, Morgantown, USA.
出版信息
J Urol. 1998 Mar;159(3):1013-5.
PURPOSE
Percutaneous endopyelotomy has been shown to be effective in the management of ureteropelvic junction obstruction in adults and secondary ureteropelvic junction obstruction in children. There are little published data regarding endopyelotomy as a primary treatment in children.
MATERIALS AND METHODS
During 3 years we performed 8 endopyelotomies and 20 open pyeloplasties for primary ureteropelvic junction obstruction and compared the results. Preoperative ureteropelvic junction obstruction was detected by renal ultrasound, excretory urogram (IVP) or renal scan. All patients were followed 1.5 to 3 years postoperatively. The success of the procedure was determined by excretory urogram, renal scan or the absence of clinical findings, with 1 failure in each group.
RESULTS
The overall success rates for endopyelotomy and open pyeloplasty were 88% and 93%, respectively. Hospital stays were essentially equal between the groups but operative time and hospital costs were higher for endopyelotomy.
CONCLUSIONS
Endopyelotomy may be performed effectively for primary ureteropelvic junction obstruction in children but with increased costs.
目的
经皮肾盂内切开术已被证明在治疗成人输尿管肾盂连接部梗阻及儿童继发性输尿管肾盂连接部梗阻方面有效。关于肾盂内切开术作为儿童原发性治疗方法的已发表数据很少。
材料与方法
在3年期间，我们对原发性输尿管肾盂连接部梗阻患者进行了8例肾盂内切开术和20例开放性肾盂成形术，并比较了结果。术前通过肾脏超声、排泄性尿路造影（IVP）或肾脏扫描检测输尿管肾盂连接部梗阻。所有患者术后随访1.5至3年。手术的成功通过排泄性尿路造影、肾脏扫描或无临床症状来确定，每组各有1例失败。
结果
肾盂内切开术和开放性肾盂成形术的总体成功率分别为88%和93%。两组的住院时间基本相同，但肾盂内切开术的手术时间和住院费用更高。
结论
肾盂内切开术可有效治疗儿童原发性输尿管肾盂连接部梗阻，但费用会增加。
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