PDF(Pubmed)
Abstract：
Background and Objectives: This study evaluated the efficacy and safety of temporary ureteral occlusion combined with urinary diversion using a single-access route created by inserting a balloon catheter through a pigtail nephrostomy drainage catheter. With this approach, we aimed to offer an alternative for patients with ureteral leaks who are suboptimal surgical candidates. Materials and Methods: This retrospective study included nine patients (eight of which were bilateral cases and one was unilateral, totaling seventeen cases) who underwent the surgery between September 2023 and March 2024. The method involved gaining percutaneous access to the pelvicalyceal system, inserting a 4-French Fogarty balloon catheter through a pigtail nephrostomy catheter, and inflating the balloon at the proximal or mid-ureter. Results: All 17 cases achieved technical successful with no major complications. The procedure effectively relieved symptoms associated with urinary leakage in most patients. However, the significant deflation of the balloon catheter occurred in five cases (29.4%), with three (17.6%) experiencing complete deflation. In these five cases, the final balloon size was 5.81 mm (range: 0-8.9 mm), confirming a 25.0% decrease in size from pre- to post-procedure. Ureteral occlusion was 28.3 d long on average (range: 8-57 d). All patients experienced symptom relief during temporary ureteral occlusion. Except for two patients lost to follow-up, three patients showed symptom improvement with only PCN and four patients underwent surgical closure of the fistula tract before or after balloon catheter removal. Conclusions: This study confirms that this approach is safe and effective.
摘要：
背景和目的：这项研究评估了通过将球囊导管通过猪尾肾造口术引流导管插入球囊导管而形成的单通路途径联合尿路改道的有效性和安全性。通过这种方法，我们的目标是为输尿管漏患者提供一种替代方案,这些患者是不理想的手术选择.材料和方法：这项回顾性研究包括9例患者（其中8例为双侧病例，1例为单侧病例，总计17例)，在2023年9月至2024年3月期间接受了手术。该方法涉及经皮进入骨盆系统，通过猪尾肾造口术导管插入4-FrenchFogarty球囊导管,并在输尿管近端或中段充气。结果：17例均获得技术成功，无重大并发症。该程序有效缓解了大多数患者与尿漏相关的症状。然而,5例（29.4%）发生球囊导管显著放气，三个(17.6%)经历完全通货紧缩。在这五个案例中,最终气球尺寸为5.81毫米（范围：0-8.9毫米），确认从手术前到手术后大小减少了25.0%。输尿管闭塞平均28.3d（范围：8-57d）。所有患者在暂时性输尿管闭塞期间症状缓解。除了两名失去随访的患者，3例患者仅出现PCN症状改善,4例患者在球囊导管拔除之前或之后接受了瘘管手术闭合.结论：本研究证实该方法是安全有效的。
