外科治疗输尿管狭窄50例

Surgery therapy for ureteric strictures (50 cases)

目的总结50例输尿管狭窄的外科治疗体会。方法 50例输尿管狭窄中腔内手术治疗38例,输尿管狭窄长度0.5～8.0 cm,用气囊或输尿管镜体扩张23例,冷刀或钬激光切开治疗15例;开放手术治疗12例,输尿管狭窄段2.0～20.0 cm。结果气囊或输尿管镜体扩张治愈或有效43.5%(10/23),冷刀或钬激光切开治愈或有效66.7%(10/15),失败18例中改开放手术10例,8例需长期更换D-J管。12例开放手术全部一次手术治愈。结论 <1.5 cm且疤痕少的输尿管狭窄腔内手术治疗效果满意,对长段或疤痕广泛的输尿管狭窄选择合适的开放手术方式可取得理想的手术效果。

【Objective】To summarize the surgery therapy for 50 cases of ureteric strictures.【Methods】38 from 50 cases of ureteric strictures were performed endourology operations.In this group,the length of strictures are 0.5～8.0 cm.Dilation of the ureter with balloon or ureteroscope body were performed in 23 cases;other 15 cases accepted endoincision with cold knife or Holmium Laser.12 cases accepted open operation while the strictures length are 2.0～20.0 cm.【Results】The curative or effective ratio of dilation is 43.5%（10/ 23）,as well as 66.7%（10/15） of endoincision with cold knife or Holmium Laser.Of 18 cases who failed with endourology procedure,10 were performed open operation,other 8 cases had to change D-J for long term.In open operation group,all patients were cured by once practice.【Conclusion】The effect is satisfied if the length of stricture is less than 1.5 cm and with a few cicatrix.However,if the stricture length is longer or has wide ureteric cicatrix,the proper open procedure is preferred and could lead to satisfied result.