膀胱肌瓣在长段输尿管缺损中应用的长期疗效

Long-Term Outcome of Bladder Muscle Flap Replacement for Long Segment Defect of Ureter

目的:观察膀胱肌瓣在长段输尿管缺损中的应用效果,探讨长段输尿管缺损后的修补方法。方法:2001年2月至2003年10月,应用膀胱肌瓣卷管修复中下段输尿管缺损的患者10例,其中8例有患侧周围相关手术史,1例为腹膜后纤维化患者,1例为输尿管下段肿瘤患者。结果:10例患者手术均顺利,成形后的肌瓣管平均长度8.4 cm,平均住院时间9.8 d,术后6周均顺利拔除双J管。术后获随访4年,所有患者上尿路积水情况明显减轻,3例存在手术侧轻度输尿管膀胱返流,2例出现输尿管与肌瓣管连接处狭窄,再次留置8 Fr双J管8周后恢复。结论:膀胱肌瓣卷管输尿管重建是处理中下段输尿管长段缺损的有效方法。

Objective： To observe the effect of bladder muscle flaps for the treatment of long defect of ureter and to investigate a suitable method for repairing long segment defect of ureter. Methods： From Feb 2001 to Oct 2003, a total of ten cases with middle and/or inferior segment ureter defect were replaced by bladder muscle flaps. Of the ten cases, eight had operation history, one had Ormond＇s syndromes, another one case had ureter tumor in the inferior segment. Results： Operations were successful in all of the 10 cases, the mean length of the formed muscle-flap tube was 8. 4 era, and average time of hospitalization was 9.8 days, the double-J tubes were removed at six weeks after operation. All patients were followed up for four years, the dropsy of upper urinay tract was alleviated obviously, three patients were observed slightly backstreaming by urethrocystography two years after operation, and two patients recurred stricture were treated by inserting Fr8 double-J tube for 8 weeks. Conclusion： It is an effective method to repair ureter defect in middle and/or inferior segment by bladder muscle flaps.