| OBJECTIVE:In this study,the author compared two surgical treatment effect of healing ureteral stricture and explored advantange of healing reteral stricture in clinical treatment,by investigating two different ways of holmium laser endoureterotomy and open surgery.METHODS:Retrospective analysis China-Japan Union Hospital of Jilin University Urology from September 2014 to August 2016 treatment of 54 cases of benign US clinical data.Preoperative combination of patients with history and improve the relevant auxiliary examination,to identify the formation of US reasons,parts and characters.To ensure that all patients are unilateral single less than 2cm of benign US,and exclude by exogenous oppression.According to the voluntary principle of patients were grouped,holmium laser endoureterotomy as the observation group,a total of 26 people,including 19 men,7 females,aged 45.39 ± 9.11 years old,narrow in the upper part of the ureter are 12 people,in the middle parts are 8 people,in the lower parts are 6people.,the narrow length is 1.25 ± 0.44 cm,the time of stricture was 11.90 ± 2.56 months,the degree of renal pelvis separation was 2.80 ± 0.49 cm;Open surgical treatment as a control group,a total of 28 people,including 20 men,8 women,aged46.54 ± 9.99 years old,narrow in the upper part of the ureter are 10 people,in the middle parts are 10 people,in the lower parts are 8 people.,the narrow length is 1.36± 0.44 cm,the time of stricture was 13.04 ± 3.44 months,the degree of renal pelvis separation was 3.01± 0.36 cm.RESULT:Both two groups were successfully completed according to the plan and confirmed intraoperative US as the benign lesions.The patients were followed up for 6 months.The effective treatment in observation group was 20 patients,and four patients were invalid,the effective rate was 76.92%;In the control group,24 patients were effective,4 were ineffective,the effective rate was 85.71%.There was no statistically significant difference in the efficacy of the same type of disease treated by two different surgical procedures(p> 0.05).The operation time of the observation group was 52.12 ± 11.91 min.The operation time of the control group was 80.03.12 ±9.78 min,and the difference between the two groups was statistically significant(p<0.01).The amount of surgical bleeding was 12.46 ± 2.70 ml in the observation group and 177.34 ± 10.70 ml in the control group,the difference between the two groups was statistically significant(p <0.01).The recovery time of gastrointestinal tract in the observation group was 2.52 ± 0.26 days.The gastrointestinal recovery time in the control group was 5.42 ± 0.42 days,the difference between the two groups was statistically significant(p <0.01).The observation group was hospitalized for 5.31 ±0.34 days.The control group was hospitalized for 9.11 ± 0.29 days,the difference between the two groups was statistically significant(p <0.01).In the observation group,the postoperative indwelling catheter was 4.42 ± 0.35 days,while the observation group was left with urinary catheter 8.30 ± 0.29 days,the difference between the two groups was statistically significant(p <0.01).There were no cases of high fever,3 cases of pain,6 cases of hematuria,1 cases of ureteral fistula and 1 cases of abdominal distension in observation group.The complication rate was 42.31%.There were two cases of high fever,6 cases of pain,9 cases of hematuria,2 cases of ureteral fistula and 3 cases of abdominal distension in observation group.The complication rate was 78.57%.The X2 examination showed that p = 0.006 <0.05,that is to say the difference was statistically significantCONCLUSION:1.For less than 2cm non-ischemic and exogenous compression of benign ureteral stricture,the use of ureteroscopic holmium laser or open surgery to achieve similar success rate and efficiency.2.Compared with open surgery,using laser endoureterotomy to treat ureteral stricture has shorter operative time,less intraoperative bleeding,shorter average hospital stay,fewer postoperative complications,and is more likely to be accepted by patients. |
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