Endoscopic treatment of benign ureterointestinal anastomotic strictures in patients with urinary diversion / 中华泌尿外科杂志

Objective To evaluate the clinical efficacy of endourologic treatment of benign uret-erointestinal anastomotic strictures in patients with urinary diversion. Methods Nine cases of benign ureterointestinal anastomotic strictures with a length of 1-3 cm following radical cystectomy and uri-nary diversion accepted endourologic treatment. 8 cases were treated by antegrade percutaneous ap-proach, 1 case by retrograde ureteroscopic approach. The strictures received balloon dilation, and ure-teral stents indewelled. Results In a follow up of 0.5-5.0 years, 1 case received percutaneous ne-phrostomy for complete ureterointestinal anastomotic atresia and refused to open operation reconstruc-tion. 5 cases had no recurrence after 2-3 endoscopic sessions. 3 cases needed long time ureteral stents indwelled. Conclusion Endourological technique for ureterointestinal strictures following urinary di-version avoided the disadvantages of open operation.

Character and significance of renal pelvic pressure in minimally invasive percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective To investigate the renal pelvic pressure(RPP) during minimally invasivepereutaneous nephrolithotomy(MPCNL),and inspect its influence to postoperative fever. MethodsThe RPP was measured by baroeeptor,and these data about pressure and postoperative fever wereevaluated statistically. Results The mean RPP was 14.72 mm Hg,the mean accumulative time of RPP≥30 mm Hg was 116.06 s. Fifteen cases(18. 75%)had a postoperative fever. Logistical analysissuggested that postoperative fever did not correlate to sex(P=0.195),age(P=0.641),urinary tractinfection (P=0.663),white blood cell≥10 × 109/L in blood routine examination postoperatively (P=0.751),once an occurrence of RPP≥40 mm Hg(P=0.662),while infection calculi (P=0.000),percutaneous tract size(P=0.029),mean RPP(P=0.036) ,mean RPP≥20 mm Hg(P=0.013),accumulative time of RPP≥30 mm Hg(P=0.010) and RPP≥30 mm Hg longer than 50 s(P=0.024)contributed to postoperative fever. Conclusions Renal pelvic pressure generally remains lower than alevel to back flow (30 mm Hg) during MPCNL. A transient renal pelvic pressure≥30 mm Hg don'tcountribute to postoperative fever,while a temporary high pressure status(50 s)would had an accumulated effect which means an enough back flow to bring a fever.