改善无管皮肤输尿管造口术的简易技术。

Simple technique for improving tubeless cutaneous ureterostomy.

作者信息

Kim Chul Jang, Wakabayashi Yoshihiko, Sakano Yuji, Johnin Kazuyoshi, Yoshiki Tatsuhiro, Okada Yusaku

机构信息

Department of Urology, Shiga University of Medical Science, Otsu, Shiga, Japan.

出版信息

Urology. 2005 Jun;65(6):1221-5. doi: 10.1016/j.urology.2004.12.009.

DOI:10.1016/j.urology.2004.12.009

PMID:15890392

Abstract

INTRODUCTION

Cutaneous ureterostomy is the simplest and safest method of all permanent urinary diversions. However, the procedure does carry a risk of stomal stenosis. We describe a simple technique for improving tubeless cutaneous ureterostomy.

TECHNICAL CONSIDERATIONS

Between June 1991 and June 2003, the Toyoda cutaneous ureterostomy was performed in 54 patients (102 renal units) with a minimum of 6 months of follow-up. Since 1998, we introduced a new technique, consisting of fixation between the anterior and posterior rectus sheath by four interrupted sutures to maintain the stability of the abdominal wall tunnel for the ureters. The ureteral patency rate was reviewed. Of the 79 renal units (77.5%) that achieved a tubeless condition, 70 (68.6%) had no hydronephrosis. The catheter-free rate improved from 60.5% (26 of 43 renal units) to 89.8% (53 of 59 renal units) with the introduction of the new surgical stabilization step for the abdominal wall tunnel.

CONCLUSIONS

This surgical modification is an effective and simple procedure that improves tubeless cutaneous ureterostomy performed with the Toyoda method.

摘要

引言

皮肤输尿管造口术是所有永久性尿液改道方法中最简单、最安全的。然而，该手术确实存在造口狭窄的风险。我们描述一种改进无管皮肤输尿管造口术的简单技术。

技术要点

1991年6月至2003年6月，对54例患者（102个肾单位）实施丰田皮肤输尿管造口术，并进行至少6个月的随访。自1998年起，我们引入一种新技术，即通过4针间断缝合在腹直肌前后鞘之间进行固定，以维持输尿管腹壁隧道的稳定性。对输尿管通畅率进行评估。在实现无管状态的79个肾单位（77.5%）中，70个（68.6%）无肾积水。随着腹壁隧道新手术固定步骤的引入，无导管率从60.5%（43个肾单位中的26个）提高到89.8%（59个肾单位中的53个）。