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Title: 腎盂尿管移行部狭窄症手術における初回不成功例の検討
Other Titles: Initial failure in open pyeloplasty for ureteropelvic junction obstruction
Authors: 若林, 賢彦  KAKEN_name
上仁, 数義  KAKEN_name
片岡, 晃  KAKEN_name
金哲, 将  KAKEN_name
吉貴, 達寛  KAKEN_name
岡田, 裕作  KAKEN_name
Author's alias: Wakabayashi, Yoshihiko
Johnin, Kazuyoshi
Kataoka, Akira
Kim, Chul Jang
Yoshiki, Tatsuhiro
Okada, Yusaku
Keywords: Adolescent
Child, Preschool
Kidney Pelvis/surgery
Middle Aged
Retrospective Studies
Treatment Failure
Treatment Outcome
Ureteral Obstruction/surgery
Urologic Surgical Procedures/methods
Issue Date: Aug-2002
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 48
Issue: 8
Start page: 475
End page: 477
Abstract: 腎盂形成術を行った腎盂尿管移行部狭窄症23例25腎(男17例,女6例,平均15.9歳).術式はAnderson-Hynes法22腎,Y-V plasty,Hellstrom法,simple pelvi-ureterostomy各1腎であった.術後平均8.6年の排泄性腎盂尿管造影による判定で,水腎症の程度が改善した初回成功例は21腎,不変及び増悪の不成功は4腎であった.不成功の原因としては,感染,尿浸潤,不適切な縫合による管腔内での肉芽形成を認めた
We retrospectively reviewed the records of 23 patients (25 kidneys) who underwent open pyeloplasty for ureteropelvic junction obstruction (UPJO) between 1980 and 2001, focusing on failures. The patients included 17 men and 6 women, ranging from 3 months to 69 years old (mean 15.9 years). The followup period was 6 months to 19 years (mean 8.6 years). Anderson-Hynes pyeloplasty, Y-V plasty, Hellstrom's operation and simple pelvi-ureterostomy were performed in 22, 1, 1 and 1 kidney, respectively. We successfully repaired 21 of 25 renal units (success rate 84.0%). Of the four patients (4 kidneys) with persistent UPJO occurring in this primary pyeloplasty series, repeat pyeloplasty was performed on 2 patients, nephrectomy on 1 patient and balloon dilatation on 1 patient. Infection and prolonged urinary drainage seem to result in fibrosis of periureteral tissues. Inadequate stitches may cause granuloma in the lumen of the anastomosis. The techniques and complications associated with open pyeloplasty are discussed.
PubMed ID: 12243072
Appears in Collections:Vol.48 No.8

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