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Long-term results of percutaneous balloon dilation for ureterointestinal anastomotic strictures
Shizuo Yagi1, Toshihiro Goto, Ken Kawamoto
1Department of Urology, Faculty of Medicine, Kagoshima University, Japan. urology@mz.kufm.kagoshima-u.ac.jp
Background:
We determined the long-term result of our percutaneous antegrade balloon dilation technique performed for adult patients with ureterointestinal anastomotic stricture between 1992 and 1997.
Methods:
Balloon dilation was performed on 13 ureterointestinal anastomotic structures in 10 patients. After a nephrostomy was performed, a guide wire was introduced into the intestinal loop through the stenotic portion under direct observation using a ureterorenoscope. Dilation was performed using the Olbert balloon dilator (30-Fr) inserted along a guide wire into the stenotic portion. A 20-Fr or 22-Fr multihole catheter was left for approximately 6 weeks. No major complications were encountered during or after these procedures. After removal of the indwelling catheters, the progress of each patient was followed fo rat least 14 months.
Results:
Additional dilation was necessary in three of 10 patients for the recurrent stricture. The balloon dilation was ineffective in two patients with a long stenosis of the ureter or a previous history of radiation therapy for uterine cancer. Eight of 10 patients showed satisfactory outcomes during the mean follow-up period of 47.1 months.
Conclusions:
Based on these results, we believe that the balloon dilation could be the first line of treatment for strictures of uro-digestive anastomosis, except for some patients with a long stenosis or a previous history of intrapelvic radiation.