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[输尿管再植术后(不包括移植)膀胱输尿管反流的内镜治疗]

[Endoscopic treatment of vesico-ureteral reflux after reimplantation of the ureter (transplants excluded)].

作者信息

Cloix P, Dawahra M, Choukair M, Viguier J L, Gelet A

机构信息

Service Urologie/Chirurgie de la Transplantation, Hôpital Edouard Herriot, Lyon.

出版信息

Prog Urol. 1992 Feb;2(1):66-71.

PMID:1299516
Abstract

O'Donnell's technique was used to treat 9 refluxing ureteric units after surgical reimplantation of the ureter in 8 patients (mean age: 45 years) between May 1986 and January 1991. The reimplantation was performed according to Cohen's technique in 5 cases (including ureteric remodelling in one case), Leadbetter's technique in 2 cases (including ureteric remodelling in one case), the Campos Freire technique in 1 case and a direct reimplantation in 1 case (with Boari). The reflux was grade II for 1 ureter, grade III for 54 ureters, grade IV for 2 ureters and grade V for 1 ureter. A single injection was performed in 5 patients and multiple injections were required in 3 patients. An associated bladder neck incision was performed in 2 male patients. No complications were observed. Correction of reflux was obtained for 8 ureteric units, i.e. 87% success with a mean follow-up of 28 months. The failure corresponded to the case of grade V reflux in a megaureter reimplanted with remodelling. The authors recommend that endoscopic treatment of reflux be performed as first-line treatment for reflux of reimplanted ureters because of the simplicity and efficacy of this technique.

摘要

1986年5月至1991年1月期间,对8例患者(平均年龄45岁)的9个反流性输尿管单位在输尿管手术再植术后采用奥唐奈技术进行治疗。5例采用科恩技术进行再植(其中1例进行输尿管重塑),2例采用利德贝特技术(其中1例进行输尿管重塑),1例采用坎波斯·弗雷雷技术,1例采用直接再植(鲍里技术)。1个输尿管反流为Ⅱ级,54个输尿管为Ⅲ级,2个输尿管为Ⅳ级,1个输尿管为Ⅴ级。5例患者进行了单次注射,3例患者需要多次注射。2例男性患者进行了相关的膀胱颈切开术。未观察到并发症。8个输尿管单位的反流得到纠正,即平均随访28个月,成功率为87%。失败病例为1例进行重塑再植的巨输尿管Ⅴ级反流。作者建议,由于该技术简单有效,内镜下治疗反流应作为再植输尿管反流的一线治疗方法。

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