Agarwal Dinesh K
Urology Unit, The Royal Melbourne Hospital, Melbourne, VIC, Australia.
Curr Urol. 2020 Jan;13(4):209-213. doi: 10.1159/000499270. Epub 2020 Jan 7.
Management of the distal ureter during radical nephroureterectomy remains a controversial issue. This article describes a simple endoscopic PolyLoop ligation technique for managing the distal ureter during radical nephroureterectomy.
This endoscopic technique was used in 6 cases to manage the distal ureter during laparoscopic-assisted radical nephroureterectomy. The distal ureter with bladder cuff was managed endoscopically. The distal ureteric orifice with 1 cm bladder cuff was circumscribed using a Collins knife. Commercially available, Olympus detachable PolyLoop was used to ligate the ureteric stump to avoid urine spillage from the upper tract. Once ureteric stump was ligated with a PolyLoop, the distal ureter was mobilized by dividing the periureteric adhesions using a Collins knife.
Distal ureter was managed successfully in all 6 cases using commercially available detachable Polyloop from Olympus. There were no perioperative complications relating to this technique.
The PolyLoop ligation technique offers a simple and safer alternative to manage the distal ureter during radical nephroureterectomy.
根治性肾输尿管切除术期间远端输尿管的处理仍是一个有争议的问题。本文描述了一种在根治性肾输尿管切除术期间处理远端输尿管的简单内镜下PolyLoop结扎技术。
该内镜技术用于6例腹腔镜辅助根治性肾输尿管切除术期间处理远端输尿管。带膀胱袖口的远端输尿管通过内镜处理。使用柯林斯刀将带有1厘米膀胱袖口的远端输尿管口周围切开。使用市售的奥林巴斯可拆卸PolyLoop结扎输尿管残端，以避免上尿路尿液外溢。一旦用PolyLoop结扎输尿管残端，使用柯林斯刀分离输尿管周围粘连，游离远端输尿管。
使用市售的奥林巴斯可拆卸Polyloop，所有6例患者的远端输尿管均成功处理。该技术无围手术期并发症。
PolyLoop结扎技术为根治性肾输尿管切除术期间处理远端输尿管提供了一种简单且更安全的替代方法。
