探讨输尿管膀胱再植术治疗腹盆腔术中输尿管损伤的疗效。

回顾性分析2018年7月至2020年11月中山大学附属第六医院收治的41例腹盆腔手术且术中怀疑输尿管损伤并经资深泌尿外科医师术中会诊后行直接插入式输尿管膀胱再植术患者的临床资料。

本组41例患者均顺利完成插入式输尿管膀胱再植术。有效随访的36例患者中位随访时间为9.3（1~24）个月，中位留置尿管天数为17（4~83） d，双J管中位停留天数为68（19~162） d。术前肌酐为（83±23）μmol/L，拔管后肌酐为（86±43）μmol/L，两者差异无统计学意义（P=0.690）。7例患者术后CT提示患侧肾积水，其中3例患者为术后新发肾积水，4例患者为术前肾积水无改善。

腹盆腔手术术中输尿管损伤一期修复效果较好，直接插入式输尿管膀胱再植术治疗腹盆腔术中输尿管损伤的疗效满意。

To explore the effect of ureterovesical reimplantation in the treatment of ureteral injury during pelvic and abdominal surgery.

A retrospective analysis of patients suffered ureteral injury during the operations, who were underwent ureteral reimplantation surgeries in the Sixth Affiliated Hospital of Sun Yat-sen University from July 2018 to November 2020.

All the 41 patients were operated successfully. Thirty-six patients were followed up for 1 to 24 months, with a median time of 9.3 months. The urinary catheter was removed 4 to 83 days after surgeries, with a median time of 17 days, and the double J stent was removed 19 to 162 days after operations, with a median time of 68 days. The preoperative creatinine was (83±23) μmol/L, it was (86±43) μmol/L after pulling out the double J stent, there was no significant difference between them. Postoperative CT showed hydronephrosis on the affected side in 7 patients, of which 3 patients got new hydronephrosis after operation, and 4 patients got no improvement in preoperative hydronephrosis.

Once ureteral injury is diagnosed during pelvic and abdominal surgery, reconstructive surgery should be performed at the same time if it is applicable. Ureterovesical reimplantation is effective in treating ureteral injury during pelvic and abdominal surgery.