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[勒迪克-卡米抗反流输尿管回肠植入术的临床评估]

[Clinical evaluation on Le Duc-Camey antireflux ureteroileal implantation].

作者信息

Yamamoto H, Nagahama T, Shishido S, Ohhigashi T, Hayakawa K, Yamamoto T, Hagiwara M, Nakazono M

出版信息

Nihon Hinyokika Gakkai Zasshi. 1989 Sep;80(9):1367-73. doi: 10.5980/jpnjurol1989.80.1367.

Abstract

Le Duc-Camey antireflux ureteroileal implantation was evaluated clinically; by applying to various types of urinary reconstruction utilizing the ileum. Nineteen ureters in 10 cases including five Kock continent ileal urinary reservoirs (Kock pouches); five ileal conduit urinary diversions and one Goodwin ileocystoplasty were performed from March 1987 to August 1988. Male and female ratio was 8 to 2 and the average age was 61.7 years old. The post operative observation period was 13.9 months on the average. The outline of the operative procedure was as follows: a 3 cm sulcus was created in the mucosa along the long axis of the ileum; the ureter was passed from the serosal surface to the luminal surface and the adventitia of the ureter and the mucosa were sutured at three points in each side using 3-0 absorbable ligature to implant the ureter in the mucosal sulcus. The ureteral end was spatulated 3 mm in the upper wall and it was fixed to the mucosa by three stitches. A ureteral stent catheter, 7-8 Fr. in diameter, was indwelled in the ureter. Additional stitches were placed to strengthen the fixation on the outside surface of Kock pouches or a Goodwin ileocystoplasty. The afferent limb was not fabricated in Kock pouches because ileoureteral reflux could be prevented by the implantation technique on the pouch. Radiological evaluation was done taking IVP, loopography, pouchgraphy and cytography periodically after the operation.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对Le Duc-Camey抗反流输尿管回肠植入术进行了临床评估;该术式应用于各种利用回肠进行的尿路重建。1987年3月至1988年8月,对10例患者的19条输尿管进行了手术,包括5例Kock可控回肠膀胱术(Kock袋)、5例回肠导管尿流改道术和1例Goodwin回肠膀胱扩大术。男女比例为8比2,平均年龄为61.7岁。术后平均观察期为13.9个月。手术步骤如下:沿回肠长轴在黏膜上创建一条3厘米的沟;输尿管从浆膜面穿过至管腔面,输尿管外膜与黏膜在两侧各三点用3-0可吸收缝线缝合,将输尿管植入黏膜沟。输尿管末端在上壁切开3毫米并通过三针固定于黏膜。留置一根直径7-8F的输尿管支架导管。在Kock袋或Goodwin回肠膀胱扩大术的外表面额外缝合以加强固定。Kock袋不制作输入襻,因为通过该植入技术可防止袋内回肠输尿管反流。术后定期进行静脉肾盂造影(IVP)、襻造影、袋造影和细胞学检查以进行影像学评估。(摘要截断于250字)

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