经皮肾穿刺顺行球囊扩张术治疗肾盂成型术后肾盂输尿管连接部狭窄

Treatment of Ureteropelvic Junction Obstruction after Laparoscopic Pyeloplasty with Antegrade Percutaneous Balloon Dilation

目的探讨经皮肾穿刺顺行球囊扩张术治疗肾盂成型术后肾盂输尿管连接部狭窄(UPJO)的疗效。方法采用经皮肾穿刺顺行球囊扩张术治疗肾盂成型术后UPJO18例,男10例,女8例,年龄15～42岁,平均年龄30岁;腹腔镜肾盂成型术后再狭窄12例;开放性肾盂成型术后再狭窄6例。结果 18例患者手术成功,无大出血、肾周感染等并发症。手术时间40～110min,平均75min。手术失血量35～80ml,平均50ml。随访12个月,治愈12例,好转4例,无效2例,有效率达88.9%。结论采用经皮肾穿刺顺行法球囊扩张术治疗肾盂成型术后UPJO创伤小、安全、疗效好,易于被病人接受。

Objective To evaluate the safety and efficacy of antegrade percutaneous balloon dilation for ureteropelvic junction obstruction (UPJO) associated with laparoscopic pyeloplasty. Methods Eighteen patients (10 males, 8 females) with UPJO after laparoscopic pyeloplasty were involved in this retrospectire study.All of the cases received antegrade percutaneous balloon dilation. Results All of the surgeries were successfully, with no severe bleeding and perinephric abscess occurred. Mean operation time was 75 minutes (range 40～110 minutes), mean bleeding volume was 50 ml (range 35～80 ml). All cases were followed up for 12 months. Twelve cases were cured, and 4 cases performed better while 2 cases developed re-stenosis. Treatment efficacy was around 88.9%. Conclusions Antegrade percutaneous balloon dilation could be considered as an safe, easier and effective minimally invasive therapy for UPJO after laparoscopic pyeloplasty.