输尿管盂连接处狭窄的手术治疗。

L B Tan, C P Chiang, C H Huang, Y H Chou, C J Wang
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摘要

本文于一九七一年至一九八六年期间,在高雄医学院附属医院共手术四十五例肾盂输尿管连接处狭窄所致肾积水患者。在单侧病例中,左肾比右肾更常见(24 ~ 13),8例(18%)双侧肾盂输尿管狭窄。45例患者中,因严重肾积水行Anderson-Hynes肾盂成形术24例(53%),Y-V成形术5例,输尿管溶解术5例,单纯肾切除术11例。除11例肾切除术外,其余34例术后放置输尿管导管11例,放置双j输尿管导管9例;另有14例未行输尿管支架引流。结果非常令人鼓舞,64%的患者临床改善,47%的患者盆腔系统改善,输尿管显影剂早期出现。比较肾盂成形术合并和不合并肾造口或输尿管支架的结果。肾造口术或输尿管支架术患者尿路感染发生率增高,住院时间延长。一般来说,接受肾造口术或输尿管支架的患者治疗效果较差。
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[Surgical treatment of ureteropelvic junction stricture].

Forty-five patients with hydronephrosis due to pelviureteric junction stricture were operated on at Kaohsiung Medical College Hospital between 1971 and 1986. In unilateral cases, the left kidney was affected more frequently than the right (24 to 13), while 8 (18%) had bilateral ureteropelvic stricture. Of the 45 cases, 24 cases (53%) underwent Anderson-Hynes pyeloplasty, 5 cases underwent Y-V plasty, 5 cases underwent ureterolysis and 11 cases underwent simple nephrectomy due to severe hydronephrosis. Except for the 11 nephrectomy cases, 11 of the remaining 34 cases had ureteral catheter placement and 9 cases had double-J ureteral catheter placement, postoperatively; another 14 cases received no ureteral stent for draining urine. The results were very encouraging with clinical improvement in 64% of the patients, and improvement in the pelviocaliceal system and early appearance of contrast medium in the ureter in 47% of the patients. The results of pyeloplasty with and without a nephrostomy or ureteral stent were compared. Patients with a nephrostomy or ureteral stent tended to have an increased incidence of urinary tract infections and longer hospital stays. In general, the results of treatment were poorer for patients with a nephrostomy or ureteral stent, than for patients without.

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