Bao Jun Sheng, He Qiqi, Li Yuzhuo, Shi Wei, Wu Gongjin, Yue Zhongjin
Department of Urology, Key Laboratory of Disease of Urological System, Gansu Nepho-Urological Clinical Center, Second Hospital of Lanzhou University, Lanzhou, Gansu, China, 730030.
Urol J. 2017 Jul 2;14(4):4055-4061.
Ureteric substitution using the Yang-Monti principle was reported as a modification of simple ileal ureter replacement. During April 2013 to June in 2015, 2 patients underwent ileal ureteral substitution using a reconfigured ileal segment of Yang Monti principle in our clinical center. Some slight modifications were made and then follow-up were carried out up to 12 months. For these 2 cases, no significant intra/post-operative complications occurred. In 1 year follow up, serum creatinine (Scr) and blood urea nitrogen (BUN) of both patients decreased to normal.Glomerular filtration rate (GFR), renogram and pyelogram showed a stable split renal function. To better understand the Yang-Monti principle and potential risks and complications, we conduct an systemic review by searching PubMed, Google Scholar and the Cochrane Library database from January 1996 through June 2016. 10 out of 644 publications were identified, which included 269 patients from cohort studies. The most usual indications for Yang-monti therapy were iatrogenic stricture and retroperitoneal fibrosis. Infection and ileus were indicated as themain short time postoperative complications while the fistula and re- strictures happened in long-term. In general,we believe Yang-Monti Principle is a safer and efficient technique for clinical partial and complete ureteral defects if patients and potential risks could be well prepared.
据报道，采用杨-蒙蒂原理进行输尿管替代是对简单回肠代输尿管术的一种改良。2013年4月至2015年6月期间，在我们临床中心有2例患者采用重新构建的符合杨-蒙蒂原理的回肠段进行回肠代输尿管术。我们做了一些细微的改良，然后进行了长达12个月的随访。这2例患者术中及术后均未出现严重并发症。在1年的随访中，两位患者的血清肌酐（Scr）和血尿素氮（BUN）均降至正常水平。肾小球滤过率（GFR）、肾图和肾盂造影显示分肾功能稳定。为了更好地了解杨-蒙蒂原理以及潜在风险和并发症，我们通过检索1996年1月至2016年6月期间的PubMed、谷歌学术和考克兰图书馆数据库进行了一项系统评价。在644篇出版物中筛选出10篇，其中队列研究包括269例患者。杨-蒙蒂术最常见的适应证是医源性狭窄和腹膜后纤维化。感染和肠梗阻被认为是主要的术后短期并发症，而瘘管和狭窄则发生在长期。总体而言，我们认为如果对患者及潜在风险做好充分准备，杨-蒙蒂原理对于临床部分及完全输尿管缺损是一种更安全有效的技术。
