Deyl Rafael Trindade, Averbeck Márcio Augusto, Almeida Gilberto Laurino, Pioner Giovani Thomaz, Souto Carlos Ary Vargas
Urology Department, Santa Casa Hospital Complex, Santo Antonio Children's Hospital, Prof. Annes Dias Street, 285, Porto Alegre, Rio Grande do Sul 90020-090, Brazil.
J Pediatr Urol. 2009 Jun;5(3):237-9. doi: 10.1016/j.jpurol.2008.11.010. Epub 2008 Dec 23.
Appendix interposition has been described as an option for surgical reconstruction of partial and total ureteral defects both in children and adults. However, to our knowledge, appendix interposition for a total left ureteral reconstruction has never been described.
We report the first case of total left ureteral reconstruction with cecal appendix to connect the renal pelvis of a native kidney to the urinary bladder in a 3-month-old child with ureteral necrosis following pyeloplasty.
Postoperative recovery was uneventful. Postoperative intravenous pyelogram showed good flow of dye from the pelvis past the appendicular graft into the bladder. After 6 months, the child was asymptomatic, within the normal growth curve for height and weight.
Total ureteral reconstruction with cecal appendix is a feasible technique in young children. Surveillance for late operative complications is required, since this is the first case of total left ureteral reconstruction with appendix to connect the renal pelvis of a native kidney to the urinary bladder.
阑尾植入术已被描述为儿童和成人部分及完全输尿管缺损手术重建的一种选择。然而，据我们所知，从未有过关于完全左输尿管重建的阑尾植入术的描述。
我们报告了首例在一名3个月大的肾盂成形术后输尿管坏死的儿童中，采用盲肠阑尾进行完全左输尿管重建，将天然肾的肾盂与膀胱相连的病例。
术后恢复顺利。术后静脉肾盂造影显示造影剂从肾盂顺利通过阑尾移植物流入膀胱。6个月后，患儿无症状，身高和体重处于正常生长曲线范围内。
盲肠阑尾完全输尿管重建术在幼儿中是一种可行的技术。由于这是首例用阑尾进行完全左输尿管重建以将天然肾的肾盂与膀胱相连的病例，因此需要对晚期手术并发症进行监测。
