Heloury Y, Bachy B, Bawab F, Mitrofanoff P
Clinique chirurgicale infantile, CHU de Rouen.
J Urol (Paris). 1988;94(1):27-31.
High anastomoses (ureteropyelic or uretero-ureteral) were performed in 14 patients for either ectopic ureter (7 cases) or uterocele (7 cases). This simple operation (one benign complication) allows conservation of a still functioning upper segment. In cases of ureterocele, aspiration of the latter eradicates it but the high operation does not treat the possibly associated reflux. Certain secondary operations are therefore necessary (2 of the 7 cases). Means for assessing upper segment function (particularly renal scan) are discussed, the presence of function justifying the conservation of this segment even if it is dysgentic and sometimes the site of nodular renal blastema. The respective indications for high anastomosis and total bladder surgery are discussed.
14例患者因异位输尿管(7例)或输尿管膨出(7例)进行了高位吻合术(肾盂输尿管吻合术或输尿管输尿管吻合术)。这种简单的手术(有1例良性并发症)能够保留仍有功能的上半段输尿管。对于输尿管膨出病例,抽吸可消除膨出,但高位手术无法治疗可能伴发的反流。因此,某些二次手术是必要的(7例中有2例)。文中讨论了评估上半段输尿管功能的方法(尤其是肾扫描),即使上半段输尿管发育不良且有时是结节状肾胚基的部位,但只要存在功能就证明保留该段输尿管是合理的。文中还讨论了高位吻合术和全膀胱手术各自的适应证。