逆行输尿管镜下良性输尿管狭窄的钬激光治疗

Holmium: YAG laser retrograde endoureterotomy for treatment of benign urereral strictures

目的探讨逆行输尿管镜下钬激光内切开术治疗输尿管狭窄的方法及远期疗效。方法采用逆行输尿管镜下钬激光内切开术治疗良性输尿管狭窄29例,术后留置F7双J管,6～8周后拔除。拔管后定期进行超声、静脉肾盂造影检查。结果29例随访24～48个月,平均36个月。症状缓解,静脉肾盂造影、泌尿系超声证实梗阻解除21例,治愈率65.5%;2例无效,肾积水、输尿管扩张无改善;6例在治疗3个月后输尿管狭窄复发。结论逆行输尿管镜下钬激光内切术治疗良性输尿管狭窄长期效果好,创伤小,并发症少。手术失败均发生在治疗后3个月内。

[ Objective ] To determine the techniques and long-term efficacy of Holmium： YAG laser retrograde endoureterotomy for benign urereral strictures. [Methods] Holmium： YAG laser retrograde endoureterotomy and were performed on 29 ureteral stricture patients. Indwelling F7 stents were left in place and were pulled out after 4 or 6 weeks postoperatively, regular follow-up was obtained with ultrasonography and intravenous pyelography. [ Results] A median 36-month follow-up was available for 29 patients （ranging from 24-48months）. Success was achieved in 21 （65.5%） patients, in which relief of symptoms and radiographic resolution of obstruction by intravenous pyelography and ultrasonography were observed. 6 patients developed recurrent strictures 3 months after operation and 2 failed. [ Conclusion ] Holmium： YAG laser retrograde endoureterotomy is associated with a long-term success rate with with less invasion, less complications for ureteral strictures. Also, failure was uniformly evident within the first 3 months after treatment.