输尿管乳头、输尿管膀胱吻合术应用于成人先天性巨输尿管症的体会

刘定益; 王健; 俞家顺; 王名伟; 张翀宇; 周文龙

doi:10.13898/j.cnki.issn.1000-2200.2015.06.012

输尿管乳头、输尿管膀胱吻合术应用于成人先天性巨输尿管症的体会

The experience of the application of direct nipple ureteroneocystomy in adults with congenital megaureter

摘要

摘要: 目的:总结输尿管乳头、输尿管膀胱吻合术应用于10例成人先天性巨输尿管症的治疗体会。方法:成人先天性巨输尿管症10例(11侧)中单侧9例, 双侧1例, 均行输尿管末端外翻成1.5~2 cm乳头后行输尿管膀胱吻合术。结果:随访3个月至10年, 10例(11侧)术后肾积水明显减轻或消失, 输尿管外形明显改观或恢复正常。结论:成人先天性巨输尿管症的诊断主要靠影像学检查, 根据输尿管不同扩张程度行裁剪, 在输尿管末端做1.5~2 cm外翻乳头及输尿管膀胱吻合, 可以起到有效抗反流和防止吻合口狭窄的作用。

Abstract: Objective:To summarize the experiences of the application of diret nipple ureteroneocystostomy in 10 adults with congenital megaureter(CM).Methods:Among 10 cases with CM(11 sides), unilateral CM in 9 cases and bilateral CM in 1 case were found.All cases were treated with ureteroneocystostomy after1.5 to 2.0 cm evaginating papillae of terminal ureter.Results:All cases were followed up for 3 months to 10 years, the postoperative hydronephrosis in 10 cases(11 sides) improved or disappeared, their ureteral profiles improved or recovered.Conclusions:The imaging examination was the major diagnostic criteria of CM in adult.The ureter was cut back according to different caliber of CM.The 1.5 to 2.0 cm evaginating papillae of terminal ureter and ureteroneocystostomy can play an effective role on preventing urine reflux and anastomotic stricture.

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