目的：报道一种新的腔内成形技术——经皮肾“三明治”腔内肾盂成形术治疗肾盂输尿管连接部梗阻（ureteropelvic junction obstruction, UPJO）的临床疗效和安全性。方法：选取2012年1月至2013年12月期间使用经皮肾“三明治”腔内肾盂成形术治疗UPJO患者71例，其中先天性UPJO 12例，医源性UPJO59例；平均狭窄段长度为(1.4±0.8) mm，5例为肾盂输尿管连接部（ureteropelvic junction, UPJ）完全闭锁，患肾平均肾小球滤过率（glomerular filtration rate, GFR）为(19.8±10.8) mL/min。超声引导下建立皮肾通道后，UPJO狭窄段使用21 F（1 F=0.33 mm）或24 F输尿管扩张球囊采用球囊扩张-切开-球囊扩张的“三明治”技术扩大流出道，所有患者留置加强型输尿管支架管（7/14 F）作为狭窄段成形后的支撑。术后2个月撤除输尿管支架管，随访12~24个月。结果：一期手术成功69例，余2例因UPJ完全闭锁行二期手术成功，手术时间（39.3±24.2）min，术后肾周血肿1例，结石残余2例，无需要输血和发生尿源性败血症病例，无需要干预的尿外渗和体腔积液病例。随访期间，64例未再次出现UPJO的临床症状和影像学变化，7例撤除支架管后出现UPJ的再狭窄，其中6例为医源性UPJO，1例为先天性UPJO患者。结论：经皮肾“三明治”腔内肾盂成形术治疗UPJO，具有操作简便、微创、安全、有效等特点，对于具有适应证的患者可以作为一线的治疗选择。

Objective：To report a new endourological technique-percutaneous “sandwich” endopyeloplasty for ureteropelvic junction obstruction (UPJO). Methods:In the study, 71 patients with UPJO had endopyeloplasty by percutaneous balloon dilation before and after endopyelotomy, so called “sandwich” endopyeloplasty. The ureter stent was removed after 2 months and all the patients were followed up at least 12 months by ultrasound, intravenous urogram (IVU) or renal scintigraphy. Results: There were 12 patients with primary UPJO, and 59 patients with iatrogenic UPJO after pyelolithotomy, pyeloplasty, ureteroscopic lithotripsy or percutaneous nephrolithotomy. The mean length of stricture was (1.4±0.8) mm while 5 cases had complete stenosis ureteropelvic junction (UPJ). The mean glomerular filtration rate (GFR) of the affected kidney was (19.8±10.8) mL/min.69 patientshad one-stage operation successfully and 2 patients with complete UPJ stenosis were recanalized in the secondary procedures. The mean time of the operation was (39.3±24.2) min. The complications included 1 case of hemotoma, and 2 cases with residual stones. In the follow-up period, 7 patients were re-obstructed. Conclusion:Percutaneous “sandwich” endopyeloplasty shows good results for UPJO of selected patients with simple operation, minimal invasiveness, quick recovery and few severe complications.