결핵성 신배협착의 내시경하 절개술
Endocalicotomy for the Management of the Tuerculous Renal Caiceal Stricture
김진호, 문한림,
소속 상세정보
김진호 ( )
단국대학교 의과대학 내과학교실
문한림 ( )
가톨릭대학교
KMID : 0358319930340020319
Abstract
The stricture of the calyx, pelvis or ureter due to renal tuberculosis had been managed like nephrectomy, partial nephrectomy, ureteroileoneocystoplasty or even pancaliceal - ileoneocysto-plasty. 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 stricute 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, 90%). 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 retrograde pyelography is mandatory just before the surgery because stricture can be progressed during Anti-Tbc chemotherapy.
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