[Percutaneous endoscopic surgery for obstructive diseases in the upper urinary tract--preliminary report]

Fifty-two patients with obstructive diseases of the upper urinary tract were treated by percutaneous endoscopic surgery between May, 1986 and July, 1989. Fifty-nine procedures consisting of endopyelotomy (24 procedures), endopyeloureterotomy (29) and balloon dilation under direct vision (6) were performed in 54 units of the urinary drainage system. Causative diseases were congenital in 24 units, scar due to calculi in 17, scar due to previous surgery in 11 and tuberculous ureteritis in 2. The postoperative follow-up periods ranged from 3-41 months, mean +/- S.D.; 12.2 +/- 7.3 months. Of the 59 procedures, 49 (83.1%) achieved improvement but 10 could not on the postoperative excretory pyelogram and/or TcDTPA renogram. Three procedures (5.5%) required blood transfusion. Retroperitoneal leakage of the perfusate was observed in 3 procedures (5.0%). No other severe complications were observed. These results indicate that this procedure may be used for the reconstructive surgery in obstructive diseases of the upper urinary tract such as the ureteropelvic junction and the proximal 1/3 ureter.