改良回肠代输尿管术的临床应用(附10例报告)

Clinical application of modified ileoureteral substitution operation (Report of 10 cases)

目的探讨改良回肠代输尿管术在泌尿外科中的临床应用。方法对我院1998年1月至2005年6月输尿管长段狭窄、巨输尿管症、肾盂成形术失败、难治性重度肾积水等10例患者行改良回肠代输尿管术。结果10例均获得随访,随访6～50个月,肾积水均明显减轻或消失,血肌酐均恢复正常。1例术后18个月发生轻度膀胱回肠反流,1例因合并心衰而死亡。结论回肠代输尿管术是一种可取的解除输尿管梗阻、治疗难治性重度肾积水和保肾的尿路重建手术,疗效较好,但仍需术前、术后充分准备及不断改进手术方式以减少并发症的发生。

Objective To investigate the application of modified ileoureteral substitution operative in urology. Methods The modified ileoureteral substitution operation was performed strictly according to operative indications on 10 patients who had long urethral stenosis, megaureter, pyeloplasty failure and heavy refractoriness nephrohydrosis from 1998 to 2005. Results Ten cases were followed up for 6 - 50 month. The symptoms of nephrohydrosis were significantly lessened or disappeared. The bladder - ileum back flow took place after operation and 18 months in 1 case. One patient was died of heart failure. Conclusion The ileoureteral substitution operation was a suitable urinary tract reestablishment procedure for removing obstruction of ureter and heavy refractoriness nephrohydrosis and protecting renal functions. Sufficient preparation before and after operation and unceasingly improved operation method is needed to reduce the complications.