Tsurusaki Toshifumi, Takehara Kousuke
Department of Urology, Nagasaki Prefectural Shimabara Hospital.
Hinyokika Kiyo. 2007 Nov;53(11):789-93.
In some patients with intractable symptoms from incurable pelvic cancer, for example, urgency, severe hematuria, fistula formation and hydronephrosis, palliative urinary diversion with intestinal segments may not be available. Percutaneous nephrostomy or indwelling of double-J ureteral stents were usually performed. However, they suffered catheter trouble and their quality of life considerably worsened. Therefore, we developed a new technique of bilateral extraperitoneal tubeless cutaneous ureterostomy with single umbilical stoma. It resulted in symptom relief in 3 patients. The advantage of this method was as follows. The dissection was entirely extraperitoneal. The operative time was short and the procedure could be performed easily. The left ureter need not be led behind the mesosigmoid. Finally, ostomy care was easy with only one bag.
例如,在一些患有无法治愈的盆腔癌且有顽固性症状(如尿急、严重血尿、瘘管形成和肾积水)的患者中,可能无法进行肠段姑息性尿路改道。通常会进行经皮肾造瘘术或留置双J输尿管支架。然而,他们遭遇了导管问题,生活质量大幅下降。因此,我们开发了一种新的技术,即单脐孔造口双侧腹膜外无管皮肤输尿管造口术。该技术使3例患者的症状得到缓解。此方法的优点如下。解剖完全在腹膜外进行。手术时间短,操作简便。左输尿管无需经乙状结肠系膜后方引出。最后,只需一个造口袋,造口护理很容易。