Kawamura Junichiro, Tani Masaki, Sumida Kimiaki, Yazawa Takefumi, Kawasoe Junya, Yamamoto Michihiro, Harada Hideki, Yamamoto Hidekazu, Zaima Masazumi
Department of Surgery, Shiga Medical Center for Adults, 5-4-30 Moriyama, Moriyama, Shiga, 524-8524, Japan.
Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno Higashi, Osaka Sayama, Osaka, 589-8511, Japan.
Int J Colorectal Dis. 2017 Jan;32(1):135-138. doi: 10.1007/s00384-016-2672-9. Epub 2016 Oct 6.
Cancerous involvement of a ureter is sometimes encountered in pelvic surgery for malignancy. We usually perform transureteroureterostomy (TUU) in cases of unilateral lower ureteral cancerous involvement. We report the outcomes in patients treated with TUU in our institute.
We retrospectively reviewed the medical records of 11 patients who underwent TUU between June 2006 and September 2015.
The primary disease was colon cancer in five patients, rectal cancer in four, and uterine cervical cancer and ovarian cancer in one patient each. Early postoperative complications relevant to TUU occurred in four patients; however, three patients were managed conservatively and recovered quickly. Only one patient developed ureteral obstruction, which resulted from anastomotic hematoma. Follow-up periods ranged from 5 to 78 months with a median of 28 months. The median estimated glomerular filtration rate before and after TUU was 59 ml/min (range, 31-90 ml/min) and 62.0 ml/min (range, 43-127 mL/min), respectively. No patients experienced worsening of their renal function or recurrent urinary tract infection.
Short-term outcomes are good and long-term renal function is maintained following TUU. TUU is considered a feasible technique for ureteral reconstruction for pelvic malignancy, and TUU has great potential in the era of multimodal therapy.
在盆腔恶性肿瘤手术中有时会遇到输尿管癌浸润的情况。对于单侧下段输尿管癌浸润病例，我们通常进行输尿管-输尿管吻合术（TUU）。我们报告了在我院接受TUU治疗的患者的治疗结果。
我们回顾性分析了2006年6月至2015年9月期间接受TUU手术的11例患者的病历。
原发性疾病为结肠癌5例，直肠癌4例，子宫颈癌和卵巢癌各1例。4例患者术后早期出现与TUU相关的并发症；然而，3例患者经保守治疗后迅速康复。仅1例患者因吻合口血肿导致输尿管梗阻。随访时间为5至78个月，中位时间为28个月。TUU术前和术后的中位估计肾小球滤过率分别为59 ml/min（范围31 - 90 ml/min）和62.0 ml/min（范围43 - 127 ml/min）。无患者出现肾功能恶化或复发性尿路感染。
TUU术后短期效果良好，长期肾功能得以维持。TUU被认为是盆腔恶性肿瘤输尿管重建的一种可行技术，并且在多模式治疗时代具有巨大潜力。
