Xing Nian-zeng, Song Li-ming, Niu Yi-nong, Zhang Jun-hui, Wang Jian-wen, Tian Xi-quan
Department of Urology, Capital Medical University, Beijing, China.
Zhonghua Yi Xue Za Zhi. 2012 Jan 10;92(2):114-6.
To introduce a novel technique of ureterointestinal anastomosis for urinary diversion and report the preliminary clinical data.
Between June 2007 and June 2011, a total of 50 patients underwent radical cystectomy and ileal neobladder for invasive bladder carcinoma or carcinoma in situ. A novel, separate and direct end-to-end technique for ureteral reimplantation to the entrance of a segment of ileum was applied. in all patients. Details are as follow. The entrance of afferent loop was divided equally in to two lumens. Then each ureter was directly, end-to-end anastomosed to the above lumens respectively after lengthwise incisions for 1.5 cm. The mean follow-up period was 22 months (range, 3 - 48 months).
Ureterointestinal anastomosis was performed successfully in 100 units. The operative durations were (18.4 ± 4.2) minutes. Ureteral stricture developed in 4 of 100 (4%) units and refluxing in 6 of 100 (6%) units. One patient with stricture was successful repaired by balloon dilation.
With low stricture and reflux rates, this novel procedure of ureterointestinal anastomosis is simple to handle and worthy of further promotion.
介绍一种用于尿流改道的新型输尿管肠吻合技术,并报告初步临床数据。
2007年6月至2011年6月期间,共有50例患者因浸润性膀胱癌或原位癌接受了根治性膀胱切除术和回肠新膀胱术。所有患者均采用一种新型的、单独且直接的输尿管端端再植技术,将输尿管再植至一段回肠的入口处。具体如下。将输入袢入口平均分为两个腔。然后,在纵行切开1.5 cm后,将每条输尿管分别直接端端吻合至上述腔。平均随访期为22个月(范围3 - 48个月)。
100个单位的输尿管肠吻合均成功完成。手术时间为(18.4±4.2)分钟。100个单位中有4个(4%)出现输尿管狭窄,6个(6%)出现反流。1例狭窄患者经球囊扩张成功修复。
这种新型输尿管肠吻合术狭窄和反流率低,操作简单,值得进一步推广。