探讨斜跨位上下联通置入Allium覆膜输尿管支架治疗输尿管狭窄的手术技巧和经验分享，评估其安全性和疗效。

回顾性收集56例输尿管狭窄的患者资料，15例双侧狭窄，41例一侧狭窄，所有患者均采用斜跨位上下联通（45°半腰联合截石位）的术式置入Allium覆膜输尿管支架，即硬镜和软镜同时进镜，找到狭窄段后，经过尿道逆行置入Allium覆膜输尿管支架，其中20例患者采取多根串联置入，一共成功置入Allium输尿管支架94根。通过比较患者术前和术后血肌酐、肾盂分离情况，分析术后并发症的发生情况，初步评估斜跨位上下联通置入Allium覆膜输尿管支架疗效和安全性。

术后平均随访时间为（11±6）个月。术前平均肾盂分离（29±9）mm，术前血肌酐117（54～966）μmol/L，末次随访血肌酐103（56～317）μmol/L，末次随访平均肾盂分离（18±7）mm，与术前比较，差异有统计学意义（P<0.001）。术后随访中发现6例患者在一周内出现血尿、尿频等尿路刺激症状，8例患者腰痛，经对症处理后症状缓解。1例8个月后支架移位至膀胱，实施Allium覆膜输尿管支架更换和双J管置入后肾积水明显缓解。

采用斜跨位上下联通置入Allium覆膜输尿管支架治疗输尿管狭窄术后并发症较少，通畅率较高，安全有效。

To explore the surgical techniques and experiences of Allium ureteral stents (URS) in treating ureteral stricture with semisupine-lithotomy position.

The clinical data of 56 patients treated at Sun Yat-sen Memorial Hospital, Sun Yat-sen University were analyzed retrospectively. 15 patients had bilateral stenosis, 41 had unilateral stenosis. All patients were placed with the Allium URS in the semisupine-lithotomy position (45° semi-lumbar combined lithotomy position), retrograde rigid ureteroscope and flexible ureteroscope were inserted simultaneously, looking for location of strictures. Allium URS were inserted retrogradely with transureteroscope when the two ureteroscopes were connected. In 20 patients, multiple ureteral stents were placed in series on the stenotic side, and 94 Allium URS were successfully placed. Preoperative and postoperative serum creatinine, renal pelvis separation and postoperative complications were analyzed, and the feasibility, safety, and efficacy were assessed.

After the operation, the average follow-up time was (11±6) months. Renal pelvis separation was (18±7) mm. The preoperative mean renal pelvis separation was (29±9) mm, preoperative creatinine level was 117(54-966) μmol/L, and the last follow-up creatinine level was 103(56-317) μmol/L, the last follow-up renal pelvis separation was (18±7) mm, which were significantly improved (P<0.001). Postoperative follow-up result revealed six cases with urinary irritation symptoms such as hematuria and urinary frequency within one week, and eight cases with back pain, all of them were relieved after symptomatic treatment. One case had stent migration to the bladder after 8 months and underwent Allium URS replacement and bilateral double-J stent placement, by the end of the follow-up period, the patient's hydronephrosis had significantly improved compared to before.

The use of Allium membrane ureteral stents at semisupine-lithotomy position for the treatment of ureteral strictures resulted in few postoperative complications, high patency rates, and was safe and effective.