先天性腎盂尿管移行部通過障害に対するEndopyelotomyの治療成績と合併症

Abstract

1)10例11腎にendopyelotomyを施行し10腎で水腎の改善がえられた。2)endopyelotomyによる腎動脈の損傷例を1例とstent留置中の腎盂腎炎を2例経験した。3)血管性の腎盂尿管移行部通過障害が疑われる症例ではendopyelotomy施行前に動脈造影が必要である

We treated eleven cases of primary ureteropelvic junction obstruction with percutaneous endopyeltomy. Endopyelotomy was successful in nine of the eleven cases. Complications during and after endopyelotomy occurred in three cases, two of which had pyelonephritis and the other severe postoperative hemorrhage requiring blood transfusion due to incision of a posterior crossing vessel. In this last case, the kidney was supplied by three arteries. The lower segmental artery passed behind the ureter. We emphasized that angiography should be performed to rule out the presence of a posterior crossing vessel before endopyelotomy, when it is doubtful if an extrinsic cause of ureteropelvic junction obstruction is present.