经尿道输尿管镜下微创治疗儿童输尿管术后再次狭窄 12例回顾分析
摘要
Objective: To explore the clinical efficacy of the minimally-invasive treatment of ureteral postoperative stenosis with self-made electrotome, ureteroscope hard expansion and ureteral stents indwelled. Methods : A retrospective analysis of 12 cases with ureteral postoperative strictures (10 in the upper, 1 in the middle, 1 in the lower ureters, 10 cases of male, female 2 cases, average 2.1 years) from June 2012 to April 2014 was made, the length from 0.2cm to 1.5 cm, with an average of 0.5 cm. Renal function were moderately impaired in 6 cases, severely impaired in 6 cases, underwent the therapy of ureteral stenosis with self-made micro-probe electrotome and ureteroscope hard expansion, postoperatively, one 4.7 or 6F ureteral stents were remained indwelling for 6～8 weeks. Results : 12 cases completed the operation smoothly, the operative duration was 35～65 minutes (average 46 minutes). No severe complications were accompanied. Postoperative hospital stays for 7～9 days, an average of 8.3 days. with a median follow-up 8 months (ranging form 1～20 months), success was achieved in 10 of the 12 children, 2 cases were unsuccessful so as to undergo pyeloureteroplasty on open surgery once again because of the long ureteral narrow（the length over 1.2cm）and recovered eventually. Conclusion : Minimally-invasive ureteroscopy combined with self-made electrotome ureteroscope hard expansion and ureteral stents indwelled is one of the effective methods for treatment of ureteral postoperative stenosis which worth further promotion clinical application, the operation effect is exact, little pain and quick recovery, it can be used to short period ( 1.2cm ) that requires to open surgery.