- 期刊
Ureteropelvic Junction Obstruction: Comparison of Open Pyeloplasty and Endopyelotomy in 45 Patients
輸尿管腎盂聯接處狹窄：腎盂成形術與內視鏡腎盂切開術四十五病例之比較分析
摘要
治療輸尿管腎盂聯接處狹窄，傳統的監盂成形術已有了相當的成功率，但是近年來由於經皮腎臟造廔術及輸尿管鏡手術的進步，經由內視鏡來切開輸尿管腎盂聯接狹窄處漸漸廣泛的被採用，它具有更短住院天數、術後疼痛減輕及恢復迅速等優點，更重要的是和傳統的腎盂成形術有不相上下的成功率。本文將近年來所累積的病例加以分析比較，以有限的經驗顯示經皮腎造廔內視鏡切開術及藉由輸尿管鏡的逆行性內視鏡切開術的優越性，他們的平均住院日數為7.1日及3日，比起傳統的手術10.3日縮短不少，並且減少術後麻醉鎮痛劑使用劑量，因此我們深信，經由內視鏡來處理輸尿管腎盂聯接處狹窄將成為優先考慮的治療方法。
並列摘要
Ureteropelvic junction (UPJ) obstruction has traditionally been repaired surgically by open pyeloplasty with high success rate, but endopyelotomy has been recently accepted as a primary procedure for the management of UPJ obstruction. Since endopyelotomy was first performed in our hospital in 1988, a total of 45 patients with 47 UPJ obstructions had been encountered until 1996. The majority (39/47) of UPJ obstructions were primary and the rest (8/47) had a history of previous open surgery. The results were compared between 19 obstructions with endopyelotomy (15 by percutaneous procedure, 4 by ureteroscopic manipulation) and 28 obstructions with open pyeloplasty. The patients after endopyelotomy recovered more quickly with shortened hospital days than the patients of open pyeloplasty (7.1 days, 3 days and 10.3 days). The success rate appeared comparable in two groups with 89.47% of enodpyelotomy and 89.28% of open pyeloplasty. We suggest that the endopyelotomy be the first choice for the management of UPJ obstruction.