Long-term results of percutaneous balloon dilation for ureterointestinal anastomotic strictures.
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.
Department of Urology, Faculty of Medicine, Kagoshima University, Japan. urology@mz.kufm.kagoshima-u.ac.jp
Shizuo
S
Yagi
Toshihiro
T
Goto
Ken
K
Kawamoto
Hiroshi
H
Hayami
Shinji
S
Matsushita
Masayuki
M
Nakagawa
D000328:Adult; D000368:Aged; D002404:Catheterization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy; D016896:Treatment Outcome; D014515:Ureteral Diseases / Q000628:therapy*; D018666:Ureteroscopy; D014547:Urinary Diversion