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腔静脉后输尿管的腹腔镜治疗:病例报告及文献综述

Laparoscopic management of retrocaval ureter: case report and literature review.

作者信息

Montoya-Martínez Guillermo, Maldonado-Alcaraz Efraín, Moreno-Palacios Jorge, Serrano-Brambila Eduardo, Martínez-Vargas Adrián, Torres-Mercado León Octavio

机构信息

Servicio de Urología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México.

出版信息

Cir Cir. 2011 Jul-Aug;79(4):338-42.

Abstract

BACKGROUND

Retrocaval ureter is a rare congenital anomaly with an incidence of approx. 1/1000 live births. Recently, the laparoscopic approach has become the gold standard for treatment, relegating open surgery as a second option.

CLINICAL CASE

We present the case of a 27-year-old male with a 2-year history of colicky pain in the right flank radiating to the ipsilateral thigh and genital region. The patient was initially treated with a right double-pigtail catheter stent due to obstructive uropathy as evidenced by ultrasound. He underwent laparoscopic ureteral anteposition with a successful outcome and has remained asymptomatic during a 12-month follow-up.

CONCLUSIONS

Retrocaval ureter is a rare entity that requires a high grade of suspicion for initial diagnosis to provide adequate and opportune treatment that will have repercussions on kidney function and quality of life for the patient. Open surgery has traditionally been the treatment of choice; however, in recent decades laparoscopic surgery has been practiced more during this era of minimally invasive therapy, without yet displacing open surgery in our country.

摘要

背景

腔静脉后输尿管是一种罕见的先天性异常,发病率约为1/1000活产儿。近年来,腹腔镜手术已成为治疗的金标准,开放手术则作为第二选择。

临床病例

我们报告一例27岁男性患者,有右侧腰部绞痛2年病史,疼痛放射至同侧大腿及生殖器区域。超声检查证实存在梗阻性肾病,患者最初接受了右侧双猪尾导管支架置入治疗。他接受了腹腔镜输尿管复位术,效果良好,在12个月的随访期间一直无症状。

结论

腔静脉后输尿管是一种罕见疾病,初始诊断时需要高度怀疑,以便提供适当及时的治疗,这将对患者的肾功能和生活质量产生影响。传统上开放手术是首选治疗方法;然而,在近几十年的微创治疗时代,腹腔镜手术的应用更为广泛,但在我国尚未取代开放手术。

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