PERCUTANEOUS ENDOPYELOTOMY - 05/09/11
Résumé |
Endourologic management of ureteropelvic junction (UPJ) obstruction was introduced by Whitfield and Wickham in 1983 as a “percutaneous pyelolysis”20 and popularized shortly thereafter in the United States by Smith1 who coined the term “endopyelotomy.” Despite various nuances in the name of the procedure and in the technique performed,14, 19, 24 the basic concept is constant and involves a full-thickness incision through the obstructing proximal ureter from the ureteral lumen out to the peripelvic and periureteral fat. The incision is stented and left to heal based on the early work of Davis, who used an “intubated ureterotomy” in the course of an open operative procedure for UPJ obstruction.8
Initially, the percutaneous approach for definitive management of UPJ obstruction was limited to patients undergoing percutaneous removal of associated stones or to patients who had previously failed open pyeloplasty. The good results obtained ultimately led many centers to offer endopyelotomy as primary therapy for almost any patient with UPJ obstruction. This article reviews the indications, techniques, results, and complications associated with percutaneous management of UPJ obstruction.
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| Address reprint requests to Stevan B. Streem, MD, Department of Urology, Desk A100, Cleveland Clinic Foundation 9500 Euclid Avenue, Cleveland, OH 44195, e-mail: streems@ccf.org |
Vol 27 - N° 4
P. 685-693 - novembre 2000 Retour au numéro
Article précédent
- URETEROPELVIC JUNCTION OBSTRUCTION : Retrograde Endopyelotomy
- Stephen Y. Nakada, Matthew Johnson
- LAPAROSCOPIC PYELOPLASTY
- Günter Janetschek, Reinhard Peschel, Ferdinand Franscher
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