Department of Surgery, Saint Louis University Hospital, St. Louis, MO, USA.
Urology. 2011 Oct;78(4):952-3. doi: 10.1016/j.urology.2011.06.037. Epub 2011 Aug 16.
To illustrate a minimally invasive, well-tolerated, clinically, and cost-effective method for surgically managing a high-output, transplant ureterocutaneous fistula manifesting as chronic urinary tract infection and recurrent pyelonephritis. This method will subject the immunosuppressed patient to less morbidity and minimize risk to the functioning renal graft.
A combined percutaneous-endoscopic fistula closure method was developed using Deflux® to cystoscopically occlude the transplant ureteral orifice and Bioglue® to seal the ureter and fistula tract.
The patient was infection free, completely dry, and had no voiding dysfunction after undergoing this occlusion method.
This report demonstrates that this minimally invasive technique is a safe, well-tolerated, and effective technique that may be offered as an outpatient, first-line therapy over open or laparoscopic excision.
说明一种微创、耐受性良好、具有临床疗效且经济有效的方法，用于手术处理高输出量、移植输尿管皮肤瘘，该瘘表现为慢性尿路感染和复发性肾盂肾炎。这种方法可使免疫抑制患者的发病率降低，并将对功能正常的移植肾的风险最小化。
采用 Deflux®经膀胱镜封闭移植输尿管口，Bioglue®封闭输尿管和瘘道，联合开发了一种经皮内镜瘘管闭合方法。
患者在接受这种闭塞方法后，无感染，完全干燥，无排尿功能障碍。
本报告表明，这种微创技术是一种安全、耐受良好且有效的技术，可作为门诊一线治疗方法，优于开放性或腹腔镜切除。
