Kennedy D R, Lenaghan D
Aust N Z J Surg. 1977 Aug;47(4):486-90. doi: 10.1111/j.1445-2197.1977.tb04332.x.
Ureteric obstruction resulting from retrocaval ureter may be due to either compression of the ureter by the vena cava or stenosis of the postcaval segment. If obstruction is due to stenosis, the commonly described operation of division and anastomosis through the proximal dilated ureter or pelvis, after repositioning of the ureter, is likely to fail, as is division of the vena cava itself. Excision of the postcaval segment with anastomosis of the spatulated ureter over a Silastic splint is therefore recommended. Three case histories of patients with retrocaval ureter treated surgically are presented and support this view.
腔静脉后输尿管导致的输尿管梗阻可能是由于腔静脉对输尿管的压迫,或者腔静脉后段的狭窄。如果梗阻是由狭窄引起的,那么在输尿管重新定位后,通过近端扩张的输尿管或肾盂进行切开和吻合这一常见的手术操作很可能会失败,腔静脉本身的切开也是如此。因此,建议切除腔静脉后段,并在硅胶支架上对输尿管进行斜形吻合。本文介绍了3例接受手术治疗的腔静脉后输尿管患者的病例史,支持这一观点。