Department of Urology, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK.
King's College London School of Medicine, Guy's Campus, London SE1 1UL, UK.
Nat Rev Urol. 2016 Aug;13(8):447-55. doi: 10.1038/nrurol.2016.104. Epub 2016 Jun 28.
Radical cystectomy and urinary diversion is the gold-standard treatment for muscle-invasive and high-risk non-muscle-invasive bladder cancer. Ureteroenteric anastomotic stricture is a well-known complication of urinary diversion and is associated with serious sequelae that lead to total or partial loss of kidney function, infectious complications, and the need for additional procedures. Although the exact aetiology of benign ureteroenteric anastomotic strictures is unclear, they most likely occur secondary to ischaemia at the anastomotic region. Diagnosis can be achieved using retrograde contrast studies, CT scan or MAG3 renography. Open revision remains the gold-standard treatment for ureteroenteric anastomotic strictures; however, endourological techniques are being increasingly used and, in select patients, might be the optimal approach.
根治性膀胱切除术和尿流改道是肌层浸润性和高危非肌层浸润性膀胱癌的标准治疗方法。输尿管-肠吻合口狭窄是尿流改道的一种已知并发症，与严重的后遗症有关，可导致肾功能完全或部分丧失、感染并发症和需要额外的手术。虽然良性输尿管-肠吻合口狭窄的确切病因尚不清楚，但它们很可能继发于吻合区域的缺血。诊断可以通过逆行造影研究、CT 扫描或 MAG3 肾图来实现。开放性修复仍然是治疗输尿管-肠吻合口狭窄的金标准；然而，腔内泌尿外科技术的应用越来越多，在某些特定患者中，可能是最佳的治疗方法。
