Ramalingam Manickam, Senthil Kallappan, Ganapathy Pai Mizar
Department of Urology, KG Hospital and PG Institute, Coimbatore, India.
J Laparoendosc Adv Surg Tech A. 2008 Apr;18(2):271-5. doi: 10.1089/lap.2007.0025.
Boari flap reimplantation is one of the options for ureteric reimplantation when the diseased ureteric segment is long. Open Boari flap reimplantation is well established. In this paper, we describe laparoscopic Boari flap reimplantation in 3 patients.
Since May 2004, 3 patients had a successful laparoscopic Boari flap ureteric reimplantation. Preoperative intravenous urogram and retrograde pyelogram confirmed the length and site of the obstruction. The first patient was a 16-year-old boy with primary obstructive megaureter, with the adynamic segment extending from just below the sacro iliac joint. The second was a middle-aged diabetic lady with a long lower ureteric stricture. The third was a ureteric injury that occurred following a laparoscopic ovarian cystectomy.
The mean operative time was around 320 minutes. There were no intra- or postoperative complications. All the patients recovered well and are being followed up clinically and radiologically.
Laparoscopic Boari flap reimplantation is a challenging procedure. With increasing technical skill and confidence, one can attempt the procedure with the obvious advantage to the patient.
当病变输尿管段较长时，Boari皮瓣再植术是输尿管再植的选择之一。开放式Boari皮瓣再植术已得到充分确立。在本文中，我们描述了3例患者的腹腔镜下Boari皮瓣再植术。
自2004年5月以来，3例患者成功进行了腹腔镜下Boari皮瓣输尿管再植术。术前静脉肾盂造影和逆行肾盂造影确定了梗阻的长度和部位。第一例患者是一名16岁男孩，患有原发性梗阻性巨输尿管，无动力段从骶髂关节下方开始延伸。第二例是一名患有下段输尿管长段狭窄的中年糖尿病女性。第三例是腹腔镜卵巢囊肿切除术后发生的输尿管损伤。
平均手术时间约为320分钟。术中及术后均无并发症。所有患者恢复良好，正在接受临床和影像学随访。
腹腔镜下Boari皮瓣再植术是一项具有挑战性的手术。随着技术水平和信心的提高，人们可以尝试该手术，这对患者具有明显优势。
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