Shalhav A L, Giusti G, Elbahnasy A M, Hoenig D M, Maxwell K L, McDougall E M, Clayman R V
Division of Urology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
J Endourol. 1998 Apr;12(2):127-30. doi: 10.1089/end.1998.12.127.
We assessed the results of endourologic treatment of patients with a primary ureteropelvic junction obstruction (UPJO) caused by high insertion of the ureter into the renal pelvis (HIUPJO). A total of 10 patients 15 to 76 years old with preoperatively diagnosed HIUPJO were treated. Acucise retrograde endopyelotomy was performed in eight patients and percutaneous antegrade endopyelotomy in two. A stent was left in place for an average of 5.3 weeks. The subjective success rate, based on patient questionnaire and analog pain scales, was 80% at 27 months' average follow-up. The objective success rate, based on diuretic renal scanning or Whitaker test, was 70% at 26 months' mean follow-up. Overall, 60% of the patients had both an objectively and a subjectively successful outcome. The success rate for endopyelotomy in patients with UPJO caused by high insertion is similar to that reported for endopyelotomy in patients without high insertion. High insertion is not a contraindication to endopyelotomy.
我们评估了因输尿管高位插入肾盂（HIUPJO）导致的原发性肾盂输尿管连接部梗阻（UPJO）患者的腔内泌尿外科治疗结果。共有10例年龄在15至76岁之间、术前诊断为HIUPJO的患者接受了治疗。8例患者接受了Acucise逆行肾盂内切开术，2例接受了经皮顺行肾盂内切开术。支架平均留置5.3周。根据患者问卷和视觉模拟疼痛量表，在平均27个月的随访中，主观成功率为80%。根据利尿肾动态显像或惠特克试验，在平均26个月的随访中，客观成功率为70%。总体而言，60%的患者在客观和主观上均取得了成功。高位插入导致的UPJO患者肾盂内切开术的成功率与非高位插入患者肾盂内切开术的报道成功率相似。高位插入并非肾盂内切开术的禁忌证。
