Department of Pediatric Surgery, JJ Hospital, Grant Medical College, Mumbai, India.
Urology. 2010 Jun;75(6):1476-80. doi: 10.1016/j.urology.2009.07.1327. Epub 2009 Nov 13.
To find appropriate ureteric substitute in the pediatric age group.
Retrospective analysis was done from 2003 to 2008 of all patients operated in our hospital who had undergone ureteric replacement. All cases were followed up to find conduit patency, renal function, and any related complication.
Ureteric replacement was performed in 5 cases. Age of the patients ranged from 6 months to 9 years. Three cases were of obstructive megaureter; 1 of redo-pyeloplasty and 1 of iatrogenic injury of the ureter. Three patients underwent partial ureteric substitution of the right ureter, and complete replacement of the left ureter with appendix was performed in 1 patient. In 1 case small bowel was used as Monti tube to substitute the ureter. At median follow-up of 23 months (14-66 months) all patients were well except 1 whose kidney function had deteriorated.
We believe that our small series supports that either appendix or small bowel should be considered as Monti's tube for ureteric replacement when confronting with short ureter in pediatric age group.
为儿科患者寻找合适的输尿管替代物。
对 2003 年至 2008 年在我院接受输尿管替代术的所有患者进行回顾性分析。所有病例均进行随访,以了解导管通畅情况、肾功能及任何相关并发症。
共进行了 5 例输尿管替代术。患者年龄为 6 个月至 9 岁。3 例为梗阻性巨输尿管症;1 例为肾盂成形术再手术,1 例为医源性输尿管损伤。3 例患者行右输尿管部分输尿管替代术,1 例患者行阑尾完全替代左输尿管。1 例患者使用小肠作为蒙蒂管替代输尿管。中位随访时间为 23 个月(14-66 个月),除 1 例患者肾功能恶化外,所有患者均恢复良好。
我们认为,我们的小系列研究支持在儿科患者中,当遇到短输尿管时,阑尾或小肠均可作为蒙蒂管替代输尿管。