title: [Cold-knife retrograde endoscopic endopyelotomy (Cutting-Balloon) in children with ureteropelvic junction obstruction: early results].
abstract: BACKGROUND
  To present our early experience in the use of Cutting-Balloon for the treatment of resistant or relapsed ureteropelvic junction obstruction (UPJO) after a prior endourological retrograde high-pressure balloon dilatation (RHPBD).
  
  
  METHODS
  Patients with progressive hydronephrosis and impaired drainage of the renal pelvis on a diuretic renal scan were treated with RHPBD. In those patients with resistant UPJO (waist persistence after dilatation) or relapsed UPJO, we consider using a Cutting-Balloon as an alternative to our current protocol (second RHPBD or open surgery). A JJ stent was placed following the procedure, and removed at 4-6 weeks. Outcomes were evaluated 3 and 6 months after stent removal, and every 6 months thereafter, repeating renal ultrasonography and diuretic renal scan.
  
  
  RESULTS
  Between 2008 and 2010 we treated with Cutting-balloon 5 patients (4 male, 1 woman) with UPJO (left side: 3 cases, right side: 1 case, bilateral: 1 case) with a mean age of 3 months (range, 10 days to 7 months). Four cases had resistant UPJO and 1 case relapsed UPJO. After the procedure, and during the follow-up period of 12 months (range, 9-18 months), no further treatment was necessary. Four patients had improvement of hydronephrosis, with normal relative renal function (RRF). One patient (RRF 18% before treatment) did not improve. No periprocedural complications occurred.
  
  
  CONCLUSIONS
  Cutting-balloon retrograde endopyelotomy seems to be a treatment with encouraging early results for resistant and relapsed UPJO, after a prior RHPBD. We believe that further clinical evaluation is needed to confirm these findings.
authors.affiliation: Hospital General Universitario Gregorio Marañón, Madrid. noelacarrera@hotmail.com
authors.forename: N
authors.initials: N
authors.lastname: Carrera
authors.forename: A
authors.initials: A
authors.lastname: Parente
authors.forename: S
authors.initials: S
authors.lastname: Rivas
authors.forename: R
authors.initials: R
authors.lastname: Romero
authors.forename: J M
authors.initials: JM
authors.lastname: Angulo
mesh_terms: D003452:Cryosurgery / Q000295:instrumentation* / Q000379:methods*; D004724:Endoscopy; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007682:Kidney Pelvis / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D014517:Ureteral Obstruction / Q000601:surgery*