Zhong Wenlong, Hong Peng, Ding Guangpu, Yang Kunlin, Li Xuesong, Bao Junsheng, Bao Guochang, Cui Liang, Men Changping, Li Zhe, Zhang Peng, Chu Ning, Zhou Liqun
Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Center, Peking University, No.8 Xishiku St, Xicheng District, Beijing, 100034, China.
Department of Urology, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
BMC Surg. 2019 Jan 18;19(1):9. doi: 10.1186/s12893-019-0472-1.
Ileal ureter replacement is an alternative treatment for various length ureter defects. We present our experience and outcome of ileal ureter replacement in China.
We retrospectively collected data of patients who underwent ileal ureter replacement between January 2010 and January 2015. We reviewed the medical history, indications for surgery, operative data, perioperative data, and outcomes. Besides, follow-up data included symptom, urine routine test, serum creatinine, serum electrolyte status, and radiographic test.
There were 23 patients who underwent ileal ureter replacement by the same surgeon. Twenty patients were performed unilateral ileal ureter replacement, two patients underwent a combination of ileal ureter replacement and Boari flap-psoas hitch, and one received bilateral ileal ureter replacement. Among these patients, the main cause leading to surgical treatment was iatrogenic injuries (n = 15), especially urinary surgery procedure (n = 11). The median follow-up time was 45 months. There were 6 early complications and 6 late complications after operation. Only one patient suffered from small bowel-related complication and was cured by conservative treatment. Only the patient who underwent bilateral ileal ureter replacement had metabolic acidosis. And 22 patients (95.7%) had a good renal function.
Ileal ureter replacement is an efficacious and safe procedure for the therapy of long ureteral defects. With appropriate technical considerations, the complication rate may decrease.
回肠代输尿管术是治疗各种长度输尿管缺损的一种替代治疗方法。我们介绍在中国进行回肠代输尿管术的经验和结果。
我们回顾性收集了2010年1月至2015年1月期间接受回肠代输尿管术患者的数据。我们回顾了病史、手术指征、手术数据、围手术期数据和结果。此外，随访数据包括症状、尿常规检查、血清肌酐、血清电解质状态和影像学检查。
有23例患者由同一位外科医生进行了回肠代输尿管术。20例患者进行了单侧回肠代输尿管术，2例患者同时进行了回肠代输尿管术和Boari瓣-腰大肌悬吊术，1例患者接受了双侧回肠代输尿管术。在这些患者中，导致手术治疗的主要原因是医源性损伤（n = 15），尤其是泌尿外科手术操作（n = 11）。中位随访时间为45个月。术后有6例早期并发症和6例晚期并发症。只有1例患者出现与小肠相关的并发症，经保守治疗治愈。只有接受双侧回肠代输尿管术的患者出现代谢性酸中毒。22例患者（95.7%）肾功能良好。
回肠代输尿管术是治疗长段输尿管缺损的一种有效且安全的手术方法。通过适当的技术考虑，并发症发生率可能会降低。
