Endocalicotomy for the management of the tuberculous renal caliceal stricture / 대한비뇨기과학회지

The stricture of the calyx, pelvis or ureter due to renal tuberculosis had been managed like nephrectomy, partial nephrectomy, ureteroileoneocystoplasty or even pancaliceal-ileoneocystoplasty. To salvage the renal parenchyme and to treat the tuberculous renal caliceal strictures, percutaneous endocalicotomy with or without endopyelotomy was performed in 10 cases from Aug. `90 to Jan. `92. The sites of stricture were mainly upper calyx in 6 cases and lower in 4. A cold knife was used to incise the stricture and a stenting 2-sectioned(14 Fr.) endopyelotomy catheter was retained for 6 to 8 weeks. Postoperative intravenous pyelography revealed marked shrinkage of the dilated calyx in 7 cases. moderate in 1 and no change in 2(success rate, 80%). In failed 2 cases, 1 cases was performed partial nephrectomy and the other was following. There was no significant complications except 1 case of upward migration of D-J catheter. In conclusion, endocalicotomy is safe, less invasive, successful (in cases that guide wire could pass) and parenchyme preserving procedure. The retregrade pyelography is mandatory just before the surgery because stricture can be progressed during Anti-Tbc chemotherapy.

Endoscopic surgery for management in stricture of ureteropelvic junction, ureter or caliceal neck / 대한비뇨기과학회지

Recently. the endopyelotomy has been used as a first choice of treatment in selected cases of ureteropelvic or ureteral strictures. 24 consecutive cages of endourologic-tomy procedure including 12 cases of endopyelotomy. 8 cases of endoureterotomy and 4 cases of endocalicotomy were performed from Nov. '89 to May '91. The causes of stricture were previous operation (7 cases), congenital (6 cases). tuberculosis (5 cases) and others. They were all followed more than 3 months. The overall success rete was 83.3%. The success means improvement of clinical symptoms and radiographic findings. The complications were upward migration of stent (1 case), granuloma (1 case) and re-stricture (2 cases). Especially in 1 cases of caliceal stricture the success rate was 100% with no complication. Our experience indicates that endourologic-tomy procedure has relatively good success rate, low morbidity, Low complication and a shorter recovery time. Especially endocalicotomy is one of the best method to treat caliceal stricture.