经肛微创手术治疗直肠尿道瘘的操作技术与应用

Operative techniques and application in treating rectourethral fistula with transanal minimally invasive surgery

直肠尿道瘘(RUF)是一种解剖部位特殊,病情复杂,甚至可引起患者严重感染的棘手疾病,常见病因是泌尿科前列腺癌根治术后的医源性创伤、盆底外伤和局部放疗后损伤等。目前对于RUF的手术治疗进路方式包括经会阴进路、经括约肌进路、经腹进路及经肛进路等。传统的手术治疗存在创伤大、并发症发生率高、恢复慢等局限性,经肛微创手术(TAMIS)治疗RUF具有操作简便、创伤小、术后恢复快等特点。本文将就利用TAMIS治疗RUF的方法和经验进行介绍。

Rectourethral fistula(RUF)is a kind of intractable disease with special anatomical site,complex condition,and even serious infection.The common causes are iatrogenic trauma after radical prostatectomy,pelvic trauma and injury after local radiotherapy.At present,surgical approaches for RUF include transperineal approach,transsphincter approach,transabdominal approach and transanal approach.Traditional surgical treatment has the limitations of large trauma,high incidence of complications and slow recovery.Transanal minimally invasive surgery(TAMIS)for RUF has the characteristics of simple operation,small trauma and quick recovery.The purpose of this paper is to introduce the methods and experience of RUF treatment with TAMIS.