Manzoni Carlo
Divisione di Chirurgia Pediatrica, Università Cattolica del S. Cuore, Policlnico A. Gemelli, Largo A. Gemelli 8, 00168 Roma, Italy.
Rays. 2002 Apr-Jun;27(2):83-5.
Obstructive megaureter is shown by ureteral dilatation most frequently due to an obstacle at the level of ureterovesical junction. The obstacle is caused by a stenotic tract and/or the absence of peristalsis. The diagnosis of primary obstructive megaureter is usually prenatal. The pediatric surgeon together with the pediatric radiologist and nephrologist should pose the indication for surgery. The main criteria on which this approach should be indicated are the grade of megaureter and the renal function. Megaureters of low-mid grade should be followed by a "wait and see" approach because they may resolve spontaneously, while megaureters of high grade should undergo operative repair and ureterovesical reimplantation. Results are good with a low rate of complications (recurrence of stenosis or vesicoureteral reflux).
梗阻性巨输尿管表现为输尿管扩张,最常见的原因是输尿管膀胱连接处存在梗阻。梗阻由狭窄段和/或蠕动缺失引起。原发性梗阻性巨输尿管的诊断通常在产前进行。小儿外科医生应与小儿放射科医生和肾病科医生共同确定手术指征。确定该治疗方法所依据的主要标准是巨输尿管的分级和肾功能。中低分级的巨输尿管可采用“观察等待”的方法,因为它们可能会自行缓解,而高分级的巨输尿管则应接受手术修复和输尿管膀胱再植术。手术效果良好,并发症发生率较低(狭窄复发或膀胱输尿管反流)。