Tal Raanan, Bachar Gil N, Baniel Jack, Belenky Alexander
Institute of Urology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel.
Urology. 2004 Mar;63(3):438-41. doi: 10.1016/j.urology.2003.09.062.
To describe an improved technique for upper urinary tract drainage in patients with ureteroileal anastomotic stricture after radical cystectomy and urinary diversion to an ileal conduit, and to review our experience and long-term results.
From 1995 to 2002, 16 patients (18 renal units) with ureteroileal anastomotic stricture after radical cystectomy and urinary diversion to an ileal conduit underwent external-internal nephro-uretero-ileal stent placement. The procedure consisted of three stages: insertion of a percutaneous nephrostomy tube; retrograde external-internal stent placement with the help of an antegrade-inserted wire, leaving the stent's port in the stoma bag; and periodic retrograde stent exchange. The median duration of follow-up was 26.6 months.
The overall success rate was 94.7%. No serious complications occurred during the procedure or during follow-up. Patient compliance was fairly good. In 75% of the patients, the stent served as the definitive treatment, avoiding the need for surgical revision.
External-internal nephro-uretero-ileal stent placement can be used successfully and safely as a definitive treatment for anastomosis-related complications in patients after radical cystectomy and urinary diversion to an ileal conduit.
描述一种改良技术，用于根治性膀胱切除术后输尿管回肠吻合口狭窄且尿液转流至回肠膀胱的患者的上尿路引流，并回顾我们的经验和长期结果。
1995年至2002年，16例（18个肾单位）根治性膀胱切除术后输尿管回肠吻合口狭窄且尿液转流至回肠膀胱的患者接受了内外联合肾-输尿管-回肠支架置入术。该手术包括三个阶段：插入经皮肾造瘘管；在顺行插入的导丝帮助下逆行置入内外联合支架，将支架端口留在造口袋中；定期逆行更换支架。中位随访时间为26.6个月。
总体成功率为94.7%。手术过程中及随访期间未发生严重并发症。患者依从性相当好。75%的患者中，支架作为确定性治疗，避免了手术翻修的需要。
内外联合肾-输尿管-回肠支架置入术可成功、安全地用作根治性膀胱切除术后输尿管回肠吻合口狭窄且尿液转流至回肠膀胱患者吻合口相关并发症的确定性治疗方法。
