Abraham George P, Das Krishanu, Siddiaiah Avinash T, Ramaswami Krishnamohan, George P Datson, Abraham Jisha J
Department of Urology, Lakeshore Hospital and PVS Memorial Hospital, Kochi, Kerala, India.
J Minim Access Surg. 2015 Oct-Dec;11(4):236-40. doi: 10.4103/0972-9941.144095.
Long-term outcome following a laparoscopic reconstruction of ureteral strictures (US) involving solitary renal units (SRU) are scarcely reported.
The aim was to report short-term (1 year) and long-term (5 years) outcomes following a laparoscopic reconstruction of US in a solitary kidney.
Retrospective.
Records of patients operated for similar scenarios between January 2004 and January 2014 were evaluated. Clinical, biochemical and radiological profile were noted. Operative and post-operative profile were recorded. Follow-ups were scheduled at regular intervals (3 months post-procedure, 6 monthly for 2 years and yearly thereafter. Imaging was repeated at yearly intervals). Outcome was assessed by comparing pre-operative and post-operative clinical, biochemical, and radiological parameters.
SAS software 9.2 version. A P < 0.05 was inferred as statistically significant.
Seven patients underwent a laparoscopic reconstruction. Stricture location was upper ureter (n = 1), mid ureter (n = 2), lower ureter (n = 4). Surgeries performed were ureteroureterostomy, Boari flap ureteroneocystostomy and ureteroneocystostomy with psoas hitch. Four patients reported prior contralateral nephrectomy. Three patients underwent prior endoscopic correction. Four patients presented with elevated serum creatinine (>1.4 mg/dl). Till last follow-up, improvement in symptomatology and improvement or stabilisation of serum creatinine was perceived in all. Ureteral patency with resolution of hydronephrosis was observed in five patients at 1 year follow-up. Two patients revealed ureteral patency with persistence of hydronephrosis. Clinical, biochemical and radiological outcomes were maintained till long-term follow-up.
Laparoscopic reconstruction of US in SRU offers impressive short- and long-term outcome.
关于腹腔镜重建涉及孤立肾单位（SRU）的输尿管狭窄（US）后的长期结果鲜有报道。
报告腹腔镜重建孤立肾输尿管狭窄后的短期（1年）和长期（5年）结果。
回顾性研究。
评估2004年1月至2014年1月间因类似情况接受手术的患者记录。记录临床、生化和放射学资料。记录手术及术后情况。定期安排随访（术后3个月、2年内每6个月、此后每年一次。每年重复影像学检查）。通过比较术前和术后的临床、生化及放射学参数评估结果。
SAS软件9.2版。P<0.05被推断为具有统计学意义。
7例患者接受了腹腔镜重建。狭窄部位为上段输尿管（n = 1）、中段输尿管（n = 2）、下段输尿管（n = 4）。实施的手术包括输尿管输尿管吻合术、Boari瓣输尿管膀胱吻合术和带腰大肌悬吊的输尿管膀胱吻合术。4例患者曾行对侧肾切除术。3例患者曾接受内镜矫正。4例患者血清肌酐升高（>1.4mg/dl）。至最后一次随访时，所有患者症状均有改善，血清肌酐有所改善或稳定。1年随访时，5例患者输尿管通畅，肾积水消退。2例患者输尿管通畅但肾积水持续存在。临床、生化和放射学结果在长期随访中均得以维持。
腹腔镜重建SRU中的US可带来令人满意的短期和长期结果。
