经尿道腔镜下气囊扩张治疗输尿管狭窄

目的：探讨经尿道腔镜下气囊扩张治疗输尿管狭窄的效果。方法：采用经尿道腔镜下气囊扩张术治疗输尿管狭窄42例。男22例，女20例，平均年龄46岁。狭窄处位于肾盂输尿管连接处5例；输尿管上段8例，中段5例，下段24例。狭窄段长度0．5～2．0cm。结果：39例顺利通过输尿管球囊扩张导管；3例严重狭窄者失败。随访6～24个月，平均14个月。一次扩张成功37例，B超示肾盂积水均明显减轻，IVU示狭窄段通畅；2例术后取支架后狭窄复发，肾盂积水无改善。术后无明显肉眼血尿、发热，无输尿管穿孔、脱套、撕裂等并发症。结论：经尿道腔镜下气囊扩张治疗输尿管狭窄具有定位准确，扩张效果好，可重复操作，住院期短，损伤小等优点。     

输尿管气囊导管扩张术治疗输尿管吻合口瘢痕狭窄9例

目的探讨输尿管气囊扩张术治疗吻合口瘢痕狭窄的价值。方法膀胱镜或输尿管镜下将输尿管气囊扩张器放置在输尿管狭窄段，在X线监视下，输尿管气囊内高压注液扩张狭窄段，留置双J管。结果9例均获成功，8例留置双J管。6例随防3～12个月，平均5个月，肾积水、输尿管狭窄均明显改善。结论输尿管气囊扩张术治疗输尿管吻合口瘢狭窄方法简便、安全、有效、创伤小。     

经尿道气囊扩张治疗输尿管狭窄15例报告

采用Grüntzig气囊扩张管对15例获得性输尿管狭窄的患者进行经尿道气囊扩张治疗及术后随访观察,效果良好。此法操作简单,损伤小,可反复扩张,并发症少,即使不成功也不影响其他治疗方法的选择,应作为治疗良性输尿管狭窄的首选疗法,特别适用于输尿管开放手术后所致的输尿管狭窄。     

腔内气囊扩张治疗输尿管狭窄9例报告

采用美国Ｃｏｏｋ公司生产的硬质塑料输尿管气囊扩张导管在内腔镜下逆行作输尿管腔内扩张治疗９例输尿管狭窄。结果７例成功，平均随访６．５个月，效果良好，２例失败，改经开放手术治愈。认为对某些良性输尿管狭窄，气囊扩张术可作为开放的一种替代治疗方法。     

经皮肾镜联合球囊扩张治疗复发性肾结石合并输尿管上段狭窄18例报告

目的 探讨经皮肾镜联合球囊扩张治疗复发性肾结石合并输尿管上段狭窄的方法与疗效. 方法 回顾性分析2008年6月至2011年6月收治18例有肾及输尿管上段开放手术史、术后残留或复发肾结石合并输尿管上段狭窄患者的资料.男8例,女10例.年龄27～48岁.其中合并肾积水2～4 cm者14例,5～6 cm者3例,＞6 cm者1例.合并结石＜1 cm者15例,1～～3 cm者2例,＞3 cm者1例.应用经皮肾镜超声气压弹道碎石取石,联合使用球囊扩张治疗.统计分析结石清除率、肾积水变化情况及并发症,对比手术前后IVU造影及CTU检查结果情况. 结果 18例均成功建立通道,无中转开放手术病例.术后第3天肾出血1例(6％),予超选择肾动脉栓塞止血成功;双J管位置不佳1例,予内镜下调整.结石完全清除16例(89％),1例肾下盏残留结石＜5 mm未予处理,1例残留肾结石合并感染,反复治疗无效者行脓肾切除术.术后随访6～ 36个月,平均12个月,肾积水明显减少14例;肾积水无明显变化3例,再狭窄行球囊扩张后好转,术后患者IVU或CTU肾显影改善. 结论 经皮肾镜超声气压弹道联合球囊扩张是治疗复发性肾结石合并输尿管上段狭窄安全有效的方法.     

自制输尿管镜针状电刀治疗输尿管狭窄

目的探讨自制输尿管镜针状电刀在治疗输尿管狭窄中的应用价值. 方法对输尿管切开取石术后狭窄24例,息肉39例,输尿管先天性狭窄4例采用自制输尿管镜针状电刀在输尿管镜下行切开术. 结果手术时间10～30 min,术中出血量5～20 ml.随访3个月,53例(79.1%)有效,10例(14.9%)好转,4例(6.0%)无效,无严重并发症发生. 结论自制输尿管镜针状电刀治疗输尿管狭窄操作容易.     

输尿管镜下导管扩张法治疗输尿管良性狭窄25例报告

目的：探讨输尿管镜下导管扩张法治疗输尿管良性狭窄的临床疗效。方法：采用输尿管镜直视下置导管逐级扩张输尿管治疗输尿管良性狭窄25例。结果：25例均成功置管扩张和留置双J管,拔管后3个月复查肾盂积水和输尿管扩张消失或缓解。结论：输尿管镜下导管法扩张输尿管良性狭窄,可有效缓解肾盂积水所致肾功能损害及腰痛,且被患者容易接受和耐受,是一种可行的微创治疗方法。     

经输尿管镜钬激光联合球囊扩张器治疗尿道狭窄

【摘要】 目的 研究直视下钬激光尿道内切开并球囊扩张治疗尿道狭窄的疗效。方法〓2013年6月至2014年12月,共收治36例尿道狭窄患者,术前详询病史、体检、行尿流率测定及逆行尿道造影,所有病人在尿道狭窄处行直视下钬激光尿道内切开和球囊扩张,术后留置16~18Fr硅胶尿管7~21天,所有病人术后随访6~12个月,随访期间测定尿流率,必要时每3个月进行尿道逆行造影或排泄性尿路造影。结果〓第一次术后治愈30例,总体成功率为83.4%。6例再狭窄和狭窄并尿瘘。结论〓直视下钬激光尿道内切开联合球囊扩张是治疗尿道狭窄安全有效的微创方法。     

输尿管镜直视下球囊扩张治疗肾盂成形术后吻合口狭窄

目的 探讨输尿管镜直视下球囊扩张治疗肾盂成形术后吻合口狭窄的效果.方法 采用输尿管镜直视下球囊扩张治疗肾盂成形术后吻合口狭窄7例.男2例,女5例,平均33岁.均为腹腔镜肾盂离断成形术吻合口狭窄.结果 7例患者均扩张成功,直视下见狭窄段完全扩开,无严重并发症.术后2个月取出双J管,随访1年,复查B超、CT,肾孟积水明显减轻或消失,梗阻消除,腰痛等症状消失.结论 直视下输尿管镜球囊扩张对治疗肾盂成型术后并发的吻合口狭窄是一种安全有效的方法,创伤轻微,效果确切,并发症少,可作为肾盂成型术后吻合口狭窄的首选治疗方法.     

Endoscopic Balloon Dilation of Stomal Stenosis following Gastric Bypass

Background Roux-en-Y gastric bypass (RYGBP) is a common operation for severely obese patients, particularly those with co-morbid disease. Postoperative complications include those amenable to endoscopic therapy, specifically those involving the gastric stoma. Methods 26 patients with prior history of RYGBP for morbid obesity presented with symptoms of gastric outlet obstruction. Symptoms included accelerated weight loss (n = 22), nausea/vomiting (n = 26), dehydration (n = 5), and dysphagia (n = 2). Endoscopic dilatation was performed using through-the-scope dilating balloons (8–15 mm). Following dilatation, a steroid solution was injected to prevent re-stenosis. Results Patients underwent 1–7 dilating sessions (mean 2.7/patient) at 2-week intervals. Estimated stoma diameter prior to dilation ranged from 1 mm to 8 mm (mean 3.5). Following dilation, diameter of the stoma increased to 10 to 15 mm (mean 12.4) at final endoscopy. In patients requiring a single dilating session (n = 7), predilation stoma size was a mean 5.8 mm (range 3–8 mm), which increased to a mean of 12.7 mm (range 10–15 mm). In patients requiring multiple dilating sessions (n = 19), pre-dilation stoma size was a mean of 2.7 mm (range 0–4 mm), which increased to a mean of 12.2 mm (range 10–14 mm). 25 of 26 patients had good long-term response, with follow-up of 6–38 months (mean 26). No treatment-related complications occurred. All had appropriate weight loss as determined at the bariatric clinic following endoscopic therapy. Conclusions Of the complications following bariatric surgery that are amenable to endoscopic therapy, stomal stenosis appears to be relatively common. Endoscopic balloon dilation is an effective nonsurgical method for treatment of stomal stenosis, with no complications observed in this, the largest reported, series.     

逆行球囊扩张治疗输尿管狭窄

目的：评价逆行球囊导管扩张治疗输尿管狭窄的效果。方法：采用逆行球囊导管对21例输尿管狭窄患者进行扩张治疗,其中结石导致的狭窄10例,输尿管开放手术后9例,盆腔放疗术后2例,扩张后留置双J管。结果：20例扩张成功,症状和肾积水缓解,肾功能不同程度改善,2例拔出双J管后发生再狭窄,肾积水无变化或加重需进一步治疗。结论：逆行球囊扩张治疗输尿管狭窄是一种安全有效、简便易行的方法,可以作为输尿管狭窄的首选治疗。     

球囊血管成形术治疗主动脉狭窄

经皮穿刺球囊导管血管腔内成形术，在国外已广泛应用。１９８９年以来我们用此成形术治疗主动脉狭窄４例，３例成功。随访３～８个月，狭窄无复发，近期疗效比较满意。球囊血管成形术效果好且成功率高，操作简便安全可重复使用，是心血管病非手术治疗的新技术之一。     

Extensive Dilation of Distal Ureter for Endoscopic Treatment of Large Volume Ureteral Disease

Two patients with large volume disease in markedly dilated ureters were treated endoscopically by wide dilation of the ureteral orifice and passage of larger nonureteroscopic endoscopes. The larger instruments provided better vision and the ability to work with larger tools, which greatly facilitated treatment without complication in patients who otherwise would have undergone an open procedure.     

Regular Finger Dilation for Preventing Anastomotic Stenosis After Low Anterior Resection

Purpose. This study evaluated the usefulness of performing regular finger dilation (RFD) of the anastomosis to prevent stenosis after low anterior resection (LAR). Methods. Defecatory function was assessed in 22 patients who had undergone LAR more than 6 months earlier. The patients were divided into an RFD group, comprising 15 patients who had undergone regular RFD, and a non-RFD group, comprising 7 patients who had dropped out of our follow-up with RFD. The physiological and clinical findings in relation to defecatory function were compared. Results. The type and size of the stapler and anal manometric parameters were similar. The RFD group had significantly better defecatory function in terms of bowel movement and sensation of incomplete evacuation (P < 0.01, respectively) with a significantly wider anastomotic diameter and higher evacuation rate (P < 0.01, respectively). Conclusion. These findings demonstrate that RFD is useful for preventing anastomotic stenosis and achieving favorable defecatory function after LAR. Therefore, a prospective randomized study should be scheduled. Received: February 13, 2001 / Accepted: September 11, 2001     

Balloon Dilation for Endosonographic Staging in Esophageal Cancer: A Phase 1 Clinical Trial

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