切换至 "中华医学电子期刊资源库"

中华腔镜泌尿外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (06) : 559 -562. doi: 10.3877/cma.j.issn.1674-3253.2022.06.015

病例研究

去管化阑尾输尿管成形术在复杂输尿管狭窄治疗中的应用
杨晓春1, 魏宏彦2, 李海洋1, 张向向1, 罗能钦1, 刘扬1, 郭利君1, 年文博3,()   
  1. 1. 730000 甘肃省人民医院泌尿外科
    2. 741499 甘肃清水县人民医院泌尿外科
    3. 744100 甘肃华亭市第一人民医院泌尿外科
  • 收稿日期:2021-04-13 出版日期:2022-12-01
  • 通信作者: 年文博
  • 基金资助:
    甘肃省青年科技基金计划(20JR5RA319); 甘肃省自然科学基金(21JR7RA617)

Application of detubularized appendicoureteroplasty in the treatment of complex ureteral stricture

Xiaochun Yang1, Hongyan Wei2, Haiyang Li1, Xiangxiang Zhang1, Nengqin Luo1, Yang Liu1, Lijun Guo1, Wenbo Nian3,()   

  1. 1. Department of Urology ,Gansu Provincial People's Hospital, Lanzhou 730000, China
    2. Department of Urology, Qingshui County People's Hospital, Qingshui 741499, China
    3. Department of Urology, the First People's Hospital of Huating, Pingliang 744100, China
  • Received:2021-04-13 Published:2022-12-01
  • Corresponding author: Wenbo Nian
引用本文:

杨晓春, 魏宏彦, 李海洋, 张向向, 罗能钦, 刘扬, 郭利君, 年文博. 去管化阑尾输尿管成形术在复杂输尿管狭窄治疗中的应用[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(06): 559-562.

Xiaochun Yang, Hongyan Wei, Haiyang Li, Xiangxiang Zhang, Nengqin Luo, Yang Liu, Lijun Guo, Wenbo Nian. Application of detubularized appendicoureteroplasty in the treatment of complex ureteral stricture[J]. Chinese Journal of Endourology(Electronic Edition), 2022, 16(06): 559-562.

目的

探讨阑尾在复杂输尿管狭窄治疗中的应用,总结去管化阑尾瓣在复杂输尿管狭窄治疗中的经验。

方法

2019年1月至2020年10月收治的2例长段复杂输尿管狭窄患者分别在全身麻醉下行腹腔镜下和开放去管化阑尾瓣加盖输尿管成形术。记录患者术中出血量、手术时间、住院时间及术后恢复情况,分析总结手术效果。

结果

手术均顺利完成,时间分别为125 min和95 min,术后住院时间分别为8 d和11 d。术后彩超和静脉肾盂造影检查示右肾积水减轻,患者不适症状消失。

结论

去管化阑尾瓣加盖输尿管成形术治疗复杂性输尿管狭窄,手术相对简单,并发症少,值得推广。

Objective

To investigate the application of appendix in the treatment of complex ureteral stricture, and summarize the experiences and techniques of detubularized appendiceal flap in the treatment of complex ureteral stricture.

Methods

From January 2019 to October 2020, 2 patients with long-segment complex ureteral stricture underwent laparoscopic and open detubularized appendiceal flap capping ureteroplasty under general anesthesia. Intraoperative blood loss, operation time, hospital stay and postoperative recovery were recorded, and the surgical results were analyzed and summarized.

Results

The operations were both successfully completed, the time was 125 min and 95 min, and the postoperative hospital stay was 8 days and 11 days, respectively. Postoperative color Doppler ultrasound and IVP examination showed that right hydronephrosis was relieved, and the patients' discomfort symptoms disappeared.

Conclusion

Detubularized appendiceal flap capping ureteroplasty for complex ureteral stricture is relatively simple and has few complications, which is worth popularizing.

图2 复杂性输尿管狭窄病例2相关影像学检查结果及手术情况
[1]
李建华, 陈亮, 李建兴, 等. 经皮肾通道输尿管软镜联合球囊扩张治疗复杂输尿管下段狭窄的效果观察[J]. 中华医学杂志, 2014, 94(46): 3642-3645.
[2]
Reggio E, Richstone L, Okeke Z, et al. Laparoscopic ureteroplasty using on-lay appendix graft[J]. Urology, 2009, 73(4): 928.
[3]
Li Y, Li C, Yang S, et al. Reconstructing full-length ureteral defects using a spiral bladder muscle flap with vascular pedicles[J]. Urology, 2014, 83(5): 1199-1204.
[4]
Engel O, Rink M, Fisch M. Management of iatrogenic ureteral injury and techniques for ureteral reconstruction[J]. Curr Opin Urol, 2015, 25(4): 331-335.
[5]
Takeuchi M, Masumori N, Tsukamoto T. Ureteral Reconstruction With Bowel Segments: Experience With Eight Patients in a Single Institute[J]. Korean J Urol, 2014, 55(11): 742-749.
[6]
Melnikoff, AE. Sur le replacement de l'uretere par anse isolee de l'intestine grele[J]. Rev Clin Urol , 1912, 1: 601.
[7]
Die Goyanes A, Garcia Villanueva A, Lavalle Echavarria JA, et al. Replacement of the left ureter by autograft of the vermiform appendix[J]. Br J Surg, 1983, 70(7): 442-443.
[8]
Deyl RT, Averbeck MA, Almeida GL, et al. Appendix interposition for total left ureteral reconstruction[J]. J Pediatr Urol, 2009, 5(3): 237-239.
[9]
RichterF, Stock JA, Hanna MK. The appendix as right ureteral substitute in children[J]. JUrol, 2000, 163(6): 1908-1912.
[10]
Wang J, Xiong S, Fan S, et al. Appendiceal onlay flap ureteroplasty for the treatment of complex ureteral strictures: initial experience of nine patient[J]. J Endourol, 2020, 34(8): 874-881.
[11]
Barbagli G, Selli C, Tosto A, et al. Dorsal free graft urethroplasty[J]. J Urol, 1996, 155(1): 123-126.
[12]
Mangera A, Patterson JM, Chapple CR. A systematic review of graft augmentation urethroplasty techniques for the treatment of anterior urethral strictures[J]. EurUrol, 2011, 59(5): 797-814.
[13]
Duty BD, Kreshover JE, Richstone L, et al. Review of appendiceal onlay flap in the management of complex ureteric strictures in six patients[J]. BJU Int, 2015, 115(2): 282-287.
[14]
Kroepfl D, Loewen H, Klevecka V, et al. Treatment of long ureteric strictures with buccal mucosal grafts[J]. BJU Int, 2010, 105(10): 1452-1455.
[15]
Hefermehl LJ, Tritschler S, Kretschmer A, et al. Open ureteroplasty with buccal mucosa graft for long proximal strictures: A good option for a rare problem[J]. Investig Clin Urol, 2020, 61(3): 316-322.
[1] 王博, 郭利君, 李二强, 张贺林, 徐鹏, 杨晓春. 消化道与口腔黏膜组织在输尿管重建中的研究进展[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(05): 434-439.
[2] 李承勇, 郭强, 张熙, 黄建文, 郝川, 胡晓勇. 改良腹腔镜膀胱腰大肌悬吊输尿管再植术治疗医源性长段输尿管狭窄[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(02): 164-168.
[3] 庞俊, 江东根. 机器人输尿管狭窄离断成形术(右侧)[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(04): 0-.
[4] 虞勤舟, 冯星亮, 宋正尧, 邰胜, 周骏, 郝宗耀, 梁朝朝, 樊松. 机器人辅助腹腔镜系统在肾盂输尿管连接处狭窄中的临床应用[J]. 中华腔镜泌尿外科杂志(电子版), 2022, 16(04): 311-315.
[5] 陈松, 唐宇哲, 付猛, 苏博兴, 刘宇保, 肖博, 胡卫国, 李建兴. 良性输尿管狭窄的治疗:90例单中心回顾分析[J]. 中华腔镜泌尿外科杂志(电子版), 2021, 15(04): 313-316.
[6] 陈亮, 张仁涛, 丁银满, 王正权. 输尿管软镜鞘扩张法治疗输尿管狭窄合并结石初步体会[J]. 中华腔镜泌尿外科杂志(电子版), 2021, 15(03): 226-228.
[7] 徐涛, 唐鑫伟, 胡浩. 输尿管狭窄的内镜治疗:现状与未来[J]. 中华腔镜泌尿外科杂志(电子版), 2021, 15(03): 177-181.
[8] 顾绍栋, 王瑛珣, 陆如纲, 罗洪, 许祥飞, 李鑫. 双线悬吊法经腹腔入路腹腔镜下肾盂成形术[J]. 中华腔镜泌尿外科杂志(电子版), 2019, 13(05): 325-328.
[9] 刘杰, 薛江辉, 冉光勇, 胡雪辉, 王伟. 同侧两根双J管引流在结石伴息肉导致输尿管狭窄患者中的应用[J]. 中华腔镜泌尿外科杂志(电子版), 2019, 13(04): 251-254.
[10] 李柳林, 孔垂泽, 刘贤奎, 刘炀, 王建峰, 李学杰, 毕建斌. 输尿管镜下逆行球囊扩张术治疗良性输尿管狭窄的临床研究[J]. 中华腔镜泌尿外科杂志(电子版), 2019, 13(02): 85-90.
[11] 温元毅, 王勇, 马鑫, 胡成. 改良吻合技术对后腹腔镜肾盂成形术学习曲线的改进[J]. 中华腔镜泌尿外科杂志(电子版), 2018, 12(04): 244-247.
[12] 蔡忠林, 李文娟, 周川, 魏绪磐, 周逢海. 单纯球囊扩张与联合内切开治疗嵌顿性结石术后输尿管狭窄的疗效比较[J]. 中华腔镜泌尿外科杂志(电子版), 2017, 11(06): 372-375.
[13] 谢起根, 徐哲, 谢钧韬, 高文宗, 李作青, 周李. 微创技术在小儿巨大肾积水保肾治疗中的临床应用[J]. 中华腔镜泌尿外科杂志(电子版), 2017, 11(06): 368-371.
[14] 何永忠, 李逊, 杨炜青, 冯钢, 江先汉, 李天, 徐桂彬, 赖德辉, 谢清灵, 赵海波, 杨敏龙, 殷羽飞. 电刀内切开联合球囊扩张治疗输尿管狭窄[J]. 中华腔镜泌尿外科杂志(电子版), 2017, 11(02): 113-117.
[15] 叶照华, 米其武, 罗杰鑫, 李德君, 陈祐君. 输尿管结石行输尿管镜下碎石术后并发输尿管狭窄的危险因素分析[J]. 中华腔镜泌尿外科杂志(电子版), 2017, 11(01): 46-48.
阅读次数
全文


摘要