钬激光内切开术治疗输尿管及UPJ狭窄(附26例报告)

目的探讨输尿管镜下钬激光(Ho：YAG激光)内切开术治疗输尿管及肾孟输尿管连接部狭窄的疗效。方法2003年3月～2005年1月，采用经输尿管镜Ho：YAG激光内切开术治疗26例患者(其中输尿管狭窄11例及UPJ狭窄15例)，术后平均留置双J管8周，每间隔3～6个月行超声、排泄性尿路造影及肾图检查。结果平均随访10个月，22例临床症状缓解，影像学检查提示内切开段造影剂通过良好，治疗成功；4例治疗失败者再次行Ho：YAG激光内切开术，均获得满意结果；未发生手术并发症。结论输尿管镜下Ho：YAG激光内切开术对于原发性或继发性输尿管狭窄及UPJ狭窄是一种安全、有效、微创的治疗方法。

Retrograde ureteroscopic endotomy using holmium:YAG laser on treatment of ureterostenosis and ureteropelvic junction obstruction

Objective] To define the safety and efficacy of retrograde ureteroscopic endotomy using the holmium:YAG laser on the treatment of ureteral stricture and ureteropelvic junction obstruction. Methods] 11 cases of ureterostenosis and 15 cases of ureteropelvic junction obstruction were treated with retrograde ureteroscopic endotomy using the holmium: YAG laser. Postoperatively a ureteral stent remained indwelling for an average of 8 weeks. All patients were followed with serial ultrasound,excretory urography and renal scan at 3 to 6 months intervals from March 2003 to January 2005. Results] Followup was available in all cases at a mean of 10 months. Success,defined as improved drainage on radiographic study and absent clinical symptoms, were achieved in 22 patients. Repeat laser incision resulted in a successful outcome in all of the other 4 treatment failures. There were no acute surgical complications. Conclusions] Retrograde ureteroscopic endotomy with the holmium: YAG laser is a safe and minimally invasive therapy for primary and secondary ureterostenoisis and ureteropelvic junction obstruction.