铥激光内镜下切开治疗输尿管下段狭窄的疗效观察(附视频)

Efficacy of endoscopic thulium laser ureterotomy in the treatment of lower ureterostenosis

目的观察铥激光（2μm激光）内镜下切开治疗输尿管下段狭窄的疗效。方法2008年1月至2010年12月，46例输尿管下段狭窄患者行铥激光内镜下输尿管切开术。男25例，女21例，平均年龄39岁，均经超声、IVU或逆行肾盂造影、MRU检查证实。术后留置双J管8～12周，每3-6个月行超声及IVU检查并与术前对比，观察疗效。结果随访6个月至2年，31例患者一次解除狭窄，一次手术治愈率67．4％，失败者中5例经第二次手术治愈，总手术治愈率78．3％，所有患者无严重并发症。结论铥激光内镜下输尿管切开是治疗输尿管下段狭窄安全、有效的方法。

Objective To evaluate the clinical efficacy of endoscopic ureterotomy with thulium laser （2 μm laser） in the treatment of lower ureterostenosis. Methods Fourty-six patients （25 men and 21 women, mean age 39 years） who suffered from lower ureterostenosis underwent endoureterotomy with thulium laser from January 2008 to December 2010. The diagnosis was approved by uhrasound and IVU or retrograde pyelography and MRU. Postoperatively, a double J catheter remained indwelling for 8-12 weeks. All patients were followed up with ultrasound and IVU at a 3 to 6 months interval. Results Follow-up was available in all cases at a median of 9 months. Thirty-one patients who got fluent ureteral drainage on radiographic study and without clinical symptoms were considered cured. A second laser endoureterotomy cured the rest 5 patients who failed in the primary treatment. The total curative rate was 78.3%. No severe complications were observed. Conclusions Endoscopic ureterotomy with thulium laser is a safe and efficient method in the treatment of lower ureterostenosis.