University of Alabama School of Medicine, Birmingham, AL.
University of Alabama School of Medicine, Birmingham, AL.
Urology. 2020 Dec;146:248-252. doi: 10.1016/j.urology.2020.07.078. Epub 2020 Sep 19.
To report our initial experience with ureteral appendiceal interposition (UAI) in a series of adult patients undergoing ureteral reconstruction for ureteral stricture.
We retrospectively collected data of patients who underwent UAI for ureteral stricture disease from December 2015 to March of 2020. Success of surgery was defined as one that required no subsequent procedural intervention for recurrent ureteral stricture disease, or loss of kidney function.
Eleven patients underwent UAI for ureteral stricture. Etiologies for stricture disease included radiation exposure, nephrolithiasis, and iatrogenic injury. Median follow-up was 363 days. Three patients had Clavien-Dindo class III complications during their hospitalization. No patient required repeat intervention due to recurrent ureteral stricture disease. On imaging, 9 patients had no obstruction on Lasix renal scan postoperatively, or improvement in hydronephrosis on CT scan. Two patients with poor renal function preop continued to show poor function after surgery.
The use of the appendix is a safe and feasible option for ureteral reconstruction in appropriately selected adult patients when primary ureteral repair is not possible.
报告我们在一系列接受输尿管狭窄重建的成年患者中应用输尿管阑尾间置术（UAI）的初步经验。
我们回顾性收集了 2015 年 12 月至 2020 年 3 月期间因输尿管狭窄疾病接受 UAI 的患者数据。手术成功定义为无需进一步治疗复发性输尿管狭窄疾病或肾功能丧失的手术。
11 例患者因输尿管狭窄接受 UAI。狭窄疾病的病因包括辐射暴露、肾结石和医源性损伤。中位随访时间为 363 天。3 例患者在住院期间出现 Clavien-Dindo Ⅲ级并发症。无患者因复发性输尿管狭窄疾病需要再次介入治疗。影像学检查显示，9 例患者术后利尿肾扫描无梗阻，或 CT 扫描显示肾积水改善。2 例术前肾功能不佳的患者术后肾功能仍不佳。
在无法进行原发性输尿管修复时，对于适当选择的成年患者，阑尾的使用是一种安全可行的输尿管重建选择。
