激光输尿管内膜切开术治疗完全性输尿管梗阻复发!老技术的新应用。

IF 2 Q2 UROLOGY & NEPHROLOGY Research and Reports in Urology Pub Date : 2022-10-10 eCollection Date: 2022-01-01 DOI:10.2147/RRU.S371856
Naim Yarak, Skander Zouari, Omar Karray, Walid Sleiman, Alaa Abdelwahab, Stéphane Bart, Maher Abdessater
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引用次数: 1

摘要

目的:介绍应用“切光”技术治疗医源性输尿管狭窄的新内镜方法。方法:一例54岁女性患者行右侧经皮肾镜取石术治疗鹿角结石,随后两次输尿管镜检查合并严重的输尿管近端梗阻。采用顺行柔性输尿管镜和逆行刚性输尿管镜定位狭窄。在365µm Ho: YAG激光光纤(设置0.4 J, 12 Hz)的帮助下,我们成功地在狭窄病变处创建了一个小切口,顺行柔性输尿管镜可以清楚地看到刚性输尿管镜的光线,然后放置一个贯穿式导丝,固定输尿管。然后行输尿管扩张术,然后全层切开输尿管狭窄处。结石碎裂后置入单8Fr, 28cm双J输尿管支架。结果:手术时间200 min。没有失血。手术后不久没有发烧或尿路感染的迹象。Foley导尿管在术后第一天成功拔除。住院时间只有两天。结论:“切光”技术在输尿管狭窄的治疗中是一种新的应用,在以前的文献中很少有描述。这种方法的使用似乎提供了良好的结果,从而证明了这种微创技术作为传统侵入方法的替代方案的重要性。我们认为需要更大的样本和更长的随访研究,以充分确定这种方法的好处,并评估和揭示其合适的应用和缺点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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The "Cut-to-the-Light" Technique Laser Endoureterotomy for Complete Ureteral Obstruction Resurfaces! A New Application of an Old Technique.

Objective: To describe our new endoscopic approach in treating iatrogenic ureteral stenosis using the "cut-to-The-light" technique.

Methods: Case of a 54 year-old female patient who underwent a right percutaneous nephrolithotomy to treat a staghorn calculus with two subsequent complimentary ureteroscopies complicated by a severe proximal ureteral obstruction. An antegrade flexible uretereroscope and a retrograde rigid ureteroscope were used to locate the stenosis. With the aid of a 365-µm Ho: YAG laser fiber (settings 0.4 J, 12 Hz), we managed to successfully create a small incision in the stenotic lesion, the rigid ureterscopy light was clearly seen by the antegrade flexible ureteroscope and a through-and-through guidewire was then placed, securing the ureter. Ureteral dilatation was then performed followed by a full thickness incision of the ureteral stenosis. A single 8Fr, 28 cm double J ureteral stent was finally placed after stone fragmentation.

Results: The operating time was 200 mins. No blood loss. No fever or signs of UTI were seen shortly after the operation. The Foley catheter was successfully removed at day one post-op. The hospital stay was short of only 2 days.

Conclusion: The "cut-to-the-light" technique is a new application in the arsenal of ureteral stricture treatment that has been scarcely described in the literature before. The use of this method seems to offer excellent outcomes thus demonstrating the importance of this minimally invasive technique as an alternative to conventional invasive methods used. We believe that studies with larger samples and longer follow up are needed in order to fully determine the benefits of this method and to assess and reveal its suitable application and its drawbacks.

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来源期刊
Research and Reports in Urology
Research and Reports in Urology UROLOGY & NEPHROLOGY-
CiteScore
3.40
自引率
0.00%
发文量
60
审稿时长
16 weeks
期刊介绍: Research and Reports in Urology is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of adult and pediatric urology in the clinic and laboratory including the following topics: Pathology, pathophysiology of urological disease Investigation and treatment of urological disease Pharmacology of drugs used for the treatment of urological disease Although the main focus of the journal is to publish research and clinical results in humans; preclinical, animal and in vitro studies will be published where they will shed light on disease processes and potential new therapies. Issues of patient safety and quality of care will also be considered.
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