Lang E K
Department of Radiology, Louisiana State University Medical Center, New Orleans 70112.
AJR Am J Roentgenol. 1988 May;150(5):1065-8. doi: 10.2214/ajr.150.5.1065.
Percutaneous ureterocystostomy or ureteroneocystostomy is advocated as a simple, minimally invasive alternative to the extensive surgical procedures typically used in the repair of a severed distal ureter. A steerable sheath is introduced via a percutaneous nephrostomy and is advanced into the distal ureter. Reentry into the bladder is effected by a perforating guidewire (transseptal stylet). This technique was attempted in 21 patients. It was effective in 12 of 13 patients whose ureters had been severed during vaginal hysterectomy and in four of five patients who had dehiscence of an anastomosis of the ureter to a bladder pouch (uretero-Boari anastomosis). The procedure, however, failed in all three patients who had dehisced surgical ureteroneocystostomies. This experience suggests that percutaneous ureteroneocystostomy is a feasible alternative to surgery. An adequate residual length of the pelvic ureter and preservation of its vascular supply are the major factors predisposing to the success of this technique.
经皮输尿管膀胱造口术或输尿管膀胱再植术被视为一种简单的微创替代方法，可替代通常用于修复远端输尿管离断的广泛外科手术。通过经皮肾造瘘术引入可操纵鞘管，并将其推进至远端输尿管。通过穿刺导丝（经隔针芯）进入膀胱。该技术在21例患者中尝试应用。在13例输尿管在阴道子宫切除术中离断的患者中有12例有效，在5例输尿管与膀胱袋吻合口裂开（输尿管-鲍里吻合术）的患者中有4例有效。然而，在所有3例手术输尿管膀胱再植术裂开的患者中该手术均失败。这一经验表明经皮输尿管膀胱再植术是一种可行的手术替代方法。盆腔输尿管的足够残留长度及其血供的保留是该技术成功的主要因素。
