Complications of Acucise endopyelotomy

被引:27
作者
Kim, FJ
Herrell, D
Jahoda, AE
Albala, DM
机构
[1] Loyola Univ, Stritch Sch Med, Med Ctr, Dept Urol, Maywood, IL 60153 USA
[2] Edward Hines Vet Adm Hosp, Hines, IL 60141 USA
关键词
D O I
10.1089/end.1998.12.433
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Endoscopic management of ureteropelvic junction (UPJ) obstruction has a success rate of 80% to 86%. We have been performing a ureteral cutting balloon procedure under fluoroscopic control (Acucise endopyelotomy) for UPJ obstruction at Loyola University Medical Center since 1991, The overall success rate in 77 patients was 78%, All patients had a preoperative intravenous urogram or a retrograde pyelogram, but none had vascular imaging studies. Acucise endopyelotomy consisted of a posterolateral incision of the UPJ and placement of an endopyelotomy or double-J stent. Foley catheter placement at the end of the procedure demonstrated significant gross hematuria in three patients (4%), All three remained hemodynamically stable but with significant drops in postprocedure hemoglobin levels, which necessitated blood transfusion. Aggressive management included angiographic studies and embolization of lower-pole branching arteries in two patients (3%), One patient stopped bleeding after being given two units of blood, None of the patients required an open exploratory procedure. Although the risk of vascular injury is low with Acucise endopyelotomy, prolonged postoperative gross hematuria does mandate investigation and observation. Angiographic embolization appears to be the therapeutic modality of choice for patients with hemorrhagic complications after an Acucise endopyelotomy.
引用
收藏
页码:433 / 436
页数:4
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