延迟性输尿管阴道瘘的微创手术治疗
Minimally invasive surgical treatment on delayed uretero-vaginal fistula.
作者信息
Li Xinying, Wang Ping, Liu Yili, Liu Chunlai
机构信息
Department of Urology, The Fourth Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, China.
出版信息
BMC Urol. 2018 Oct 29;18(1):96. doi: 10.1186/s12894-018-0410-z.
OBJECTIVE
To evaluate the procedure of endoscopic surgery for ureterovaginal fistula (UVF) and its clinical efficacy.
MATERIALS AND METHODS
A retrospective analysis of 46 patients needing treatment for UVF with endourology technology was conducted (all patients had unilateral ureteric injury, 27 left and 19 right). Transurethral retrograde ureteric stenting or realignment retrograde/antegrade approach stenting was used to treat the fistula, and the relation between treatment and prognosis was analyzed.
RESULTS
One case failed, the patient undergoing percutaneous nephrostomy instead. Success was achieved in 45 cases, and urinary leakage was stopped 48 h after surgery. Of the 45 patients operated on, 16 had their double-J stents removed after 3-6 months, and 29 needed replacement every 6-12 months. In a postoperative follow-up of 6-36 months, 10 patients had recurrent stenosis needing ureteroscopic endoureterotomy or reexpansion with a balloon. No other complications occurred.
CONCLUSIONS
Endoscopic surgery is an effective technology in the treatment of UVF, with the advantages of being effective, reliable, less invasive, and readily accepted by patients.
目的
评估输尿管阴道瘘（UVF）的内镜手术方法及其临床疗效。
材料与方法
对46例需要采用腔内泌尿外科技术治疗UVF的患者进行回顾性分析（所有患者均为单侧输尿管损伤，左侧27例，右侧19例）。采用经尿道逆行输尿管支架置入术或逆行/顺行复位支架置入术治疗瘘管，并分析治疗与预后的关系。
结果
1例失败，改行经皮肾造瘘术。45例成功，术后48小时停止漏尿。在接受手术的45例患者中，16例在3 - 6个月后取出双J支架，29例每6 - 12个月需要更换支架。术后6 - 36个月随访中，10例患者出现复发性狭窄，需要输尿管镜下输尿管内切开术或球囊扩张术。未发生其他并发症。
结论
内镜手术是治疗UVF的有效技术，具有疗效确切、可靠、创伤小、患者易于接受等优点。
Zotero 插件