离断性肾盂成形双J管内引流术治疗肾盂输尿管连接部狭窄

目的:探讨肾盂输尿管连接部(UPJ)狭窄的手术治疗方法.方法:采用Anderson-Hynes离断性肾盂成形双J管内引流术治疗肾盂输尿管连接部狭窄58例,常规采用双J管作支架内引流,留置导尿管5～7天,术后4～8周拔除双J管,3～12个月行静脉肾盂造影复查.结果:58例手术均获成功.肾盂积水好转,狭窄解除,吻合口通畅,近期并发症5例.随访6个月～2年,未出现吻合口再狭窄、肾积水加重等远期并发症.结论:离断性肾盂成形双J管内引流术是治疗肾盂输尿管连接部狭窄的有效方法,术中使用双J管能减少术后吻合口狭窄的发生,提高手术的成功率.

Treatment of ureteropelvic junction stricture by anderson hynes pyeloplasty and double J tube internal drainage

Objectives:To evaluate the operative treatment for ureteropelvic junction(UPJ)stricture.Methods:A total of 58 cases of UPJ stricture had double-J tubes placed intraoperatively during Anderson-Hynes pyeloplasty.Urethral catheterization was maintained for 5~7 day,and the double-J tube was removed on cystoscopy 4 to 8 weeks after operation.The outcome was evaluated with ultrasonography or intravenous urography in 3 to 12 months postoperatively.Results:Success rate of management was 100%,stricture was relieved successfully in all patients,and hydronephrosis improved.Only 5 cases had complication in the near future.During follow-up of 6 months to 2 years,long-term complications,like stricture of the anastomotic mouth,and worsened kidney hydrocele,were not observed.all patients have been with satisfactory long-term results.Conclusions:Anderson-Hynes pyeloplasty was an effective method for the treatment of UPJ stricture.A double-J tubes in the operation could reduce the incidence of anastomotic mouth stricture and promote the success rate of operation.