下腔静脉后输尿管手术治疗(附20例报告)

Retrocaval Ureter( Report of 20 Cases)

目的 :总结下腔静脉后输尿管的诊治经验。方法 :回顾分析 2 0例下腔静脉后输尿管的诊治病例 ,主要症状有腰部不适、肾绞痛、血尿等。诊断主要依靠IVU和逆行输尿管肾盂造影 ,影像学表现主要为右侧肾积水 ,上端输尿管扩张、走向异常。 18例行输尿管端端吻合术 ,1例行输尿管肾盂吻合术 ,1例行肾切除术。结果 :19例整形术 1年后复查IVU提示患侧肾积水缓解 ,肾功能恢复 ,吻合口通畅 ,临床症状消失。以后每年复查 1次B超 ,最长 10年。未见肾积水加重 ,肾结石 ,血尿等。结论 :IVU和逆行输尿管肾盂造影可明确下腔静脉后输尿管的诊断 ,手术治疗有助于肾功能的恢复。

Objective:To study the diagnosis and t hera py of retrocaval ureter. Methods:Twenty cases of retrocava l ureter were studies retrospectively. The cardinal syndromes included discomfort of the back and loins, nephrocolic and bloody urines. The diagnosis mainly depen ds on IVU and retrograde urography. 18 patients underwent ureteroureterostomy,1 ureteropyeloneostomy and 1 nephrectomy. Results: All the p atients were followed up from 1 to 10 years by IVU and ultrasonography, and no n ephrohydrosis or stenosis of the anastomosis site were found. All the patients w ere free from any complaints. Conclusions: IVU and retrogr ad e urography are the cardinal means for the diagnosis of retrocaval ureter and o peration is indicated in order to improve the renal function. It is important to choose a proper time and an adequate surgical technique.