微创经皮肾穿刺钩状电刀顺行肾盂内切开治疗肾盂输尿管连接部梗阻

目的：探讨微创经皮肾穿刺（mini-PCN）钩状电刀顺行肾盂内切开治疗肾盂输尿管连接部梗阻（UPJO）的方法和疗效。方法：在C臂X线机的辅助下，采用mini—PCN技术，用F2钩状电刀顺行肾盂内切开治疗原发性及继发性UPJO患者15例。结果：15例患者均手术成功，术后症状缓解，无大出血、肾周感染等并发症。拔除双J管后1个月及3个月复查B超及静脉肾盂造影（IVP），提示肾积水消失或较术前明显减少，UPJO狭窄段消失。2例拔除双J管后6个月UPJO复发，改行开放手术治愈。结论：采用mini—PCN钩状电刀顺行肾盂内切开治疗UPJO具有操作简便、损伤小、恢复快、效果佳、价格低廉等优点。

Endopyelotomy using bent electrotome during minimally percutaneous nephrostomy for the treatment of uerteropelvic junction obstruction

Objective:To investigate the technique and effectiveness of endopyelotomy with bent electrotome during minimally percutaneous nephrostomy (mini-PCN) in treating uerteropelvic junction obstruction (UPJO).Methods:We reviewed the data of 15 cases with primary or secondary UPJO that were treated with mini invasive PCN under the guidance of C-arm fluoroscopy. Endopyelotomy were performed on all the patients by using an antegrade approach with the bent F2 electrotome.Results:A total of 15 cases were operated on successfully.The symptom was relieved postoperatively, and no severe bleeding and perinephric abscess were observed. By the first and third postoperative month, B-ultrasonography and intravenous pyelography were carried out, which demonstrated that the previous hydronephrosis had reduced or disappeared and uerteropelvic junction was unobstructed. Six months after surgery, only 2 cases recurred and were transferred to open surgery.Conclusions:Endopyelotomy by bent electrotome during mini-PCN for the treatment of UPJO is a simple and efficient method, with advantages of mini-invasion, rapid recovery and low cost.