Dagash Haitham, Sen Sudipta, Chacko Jacob, Karl Sampath, Ghosh Dhruv, Parag Pulak, Mackinnon A E
Department of Paediatric Urology, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK.
J Pediatr Urol. 2008 Feb;4(1):14-9. doi: 10.1016/j.jpurol.2007.08.004. Epub 2007 Oct 25.
Ureteric replacement in part or in total is rarely needed in children. We present our experience in using the appendix to replace the ureter.
A retrospective case note review was carried out at Sheffield Children's Hospital (UK), Ekta Institute of Child Health (Raipur, Chhattisgarh, India) and Christian Medical College Hospital (Vellore, India) of all cases of ureteric substitution using the appendix.
Ten patients were identified, operated in 2002-2007: seven males and three females with a median age of 2.5 years (range 2.5 months to 12 years). The reasons for ureteric replacement were traumatic ureteric avulsion (n=1), congenital ureteric stenosis (n=5), non-drainage following previous pyeloplasty for pelvi-ureteric junction obstruction (n=3) and ureteric stricture following reimplantation for vesico-ureteric reflux (n=1). The appendix was used in an anti-peristaltic manner in all cases, and in one case a transureteroureterostomy was performed. At a median follow up of 16months (1-72 months), all the patients were well except one whose kidney function had deteriorated.
Total or partial replacement of the ureter using the appendix, even in the first year of life, preserved renal function in nine cases. Ureteric continuity can be successfully restored in children using the appendix.
儿童很少需要部分或全部输尿管置换。我们介绍了使用阑尾替代输尿管的经验。
对英国谢菲尔德儿童医院、印度恰蒂斯加尔邦赖布尔的埃克塔儿童健康研究所和印度韦洛尔的基督教医学院医院所有使用阑尾进行输尿管置换的病例进行回顾性病例记录审查。
共确定10例患者，于2002年至2007年接受手术：7例男性和3例女性，中位年龄2.5岁（范围2.5个月至12岁）。输尿管置换的原因包括创伤性输尿管撕脱（n = 1）、先天性输尿管狭窄（n = 5）、既往肾盂成形术治疗肾盂输尿管连接部梗阻后无引流（n = 3）以及膀胱输尿管反流再植术后输尿管狭窄（n = 1）。所有病例均以抗蠕动方式使用阑尾，1例进行了输尿管输尿管吻合术。中位随访16个月（1至72个月），除1例肾功能恶化外，所有患者情况良好。
使用阑尾进行输尿管的全部或部分置换，即使在生命的第一年，9例患者的肾功能得以保留。使用阑尾可成功恢复儿童输尿管的连续性。
