Comparison Of Balloon Dilatation、Open Surgery And Laparoscopic Surgery In The Treatment Of Ureteral Stricture

Objective:Balloon dilatation、open surgery and laparoscopic surgery were three different surgical treatment of ureteral stricture.We compared them to understand the different prognosis、advantages and disadvan tages,guiding the subsequent treatment.Methods:In this paper,we selected ureteral stricture patients in the First Affiliated Hospital of Jilin University from January 2011 to December2015,which ruled out ureteral stenosis caused by complete occlusion,external compression and malignant tumor.We identified 138 patients whose ureteral stenosis was benign and stenosis Length was less than2 cm as the object of study.We divided 138 patients into A,B,C groups.Group A including 25 patients was treated with transurethral retrograde balloon dilatation.There were 21 cases in group B which was treated with laparoscopic surgery.Group C was treated with open surgery,a total of 92 patients.A,B,C three groups of patients were compared in the aspects including the operation time,intraoperative blood loss,postoperative eating time,postoperative hospital stay,perioperative complications and postoperative efficiency.Postoperative efficiency wasthe percentage of cured patients plus improved patients in the number of patients of this group.Patients who appeared to have a successful result 6months after dilation(“short-term” success)underwent routine clinical and urographic follow-up approximately 3 months later and then annually,unless new or recurrent symptoms necessitated more frequent evaluation.“Long-term” success was defined as a continued favorable result 1 year after balloon dilation and ureteral stenting.Analysis was performed using Spss software.Enumeration data were compared with the help of X2 test and measurement data were compared by means of LSD-T test.P <0.05 means significant difference.Result:During our follow-up,138 patients had nine lost visits,of whi ch the balloon dilatation group lost two,laparoscopic group lost on e,open surgery group lost 6.The operation time,intraoperative blo od loss,postoperative feeding time and postoperative hospital stay were analyzed by LSD-T test.Group A had superiority to group B and group C in the four aspects(P <0.001).Group B was superio r to group C in the aspects of intraoperative blood loss,postoperati ve eating time and hospitalization days(P <0.05).Group B had an a dvantage to group A in operation time(P <0.001).There was no st atistically significant difference in the perioperative complications be tween the three groups(P= 0.451).There was no significant difference between the three groups in “short-term” success(P=0.836).B ut the difference between the three groups was significant in“Longterm” success(P=0.016).There was no significant difference betw-een group B and group C in“Long-term” success(P=0.754).But the effective rate of the two groups was significantly higher than th-at of the group A(P <0.05).Conclusion:1、For patients whose ureteral stenosis was benign、non-compression and less than 2cm,balloon dilation has obvious advantages than laparoscopic surgery and open surgery in the operation time 、intraoperative blood loss 、 postoperative eating time 、 postoperative hospital stay.And they have equivalent short-term efficiency.But in terms of long-term efficiency,laparoscopic surgery and open surgery have advantage to balloon dilation;2 、 There was no significant difference in short-term and long-term efficiency between laparoscopic group and open surgery group.There was a significant advantage in laparoscopic group in terms of intraoperative blood loss、postoperative feeding time and postoperative hospital stay than open surgery group.3、Combined with the length of ureteral stricture、kidney function、the general physical condition,and then choose a different surgical approach.