输尿管肾盂吻合术治疗继发性长段上尿路输尿管狭窄的疗效
Efficacy of ureterocalicostomy in treating secondary long-segment upper ureteral stricture.
作者信息
Shi Xin, Gao Ziyan, Liu Jianhe, Li Zehui, Li Jiongming, Chen Tao, Zhang Haiyan, Wang Huitao, Guo Haixiang, Yang Jun, Fang Kewei
机构信息
Department of Urology, The Second Affiliated Hospital of Kunming Medical University Kunming, Yunnan Province, China.
出版信息
Int J Clin Exp Pathol. 2020 Oct 1;13(10):2554-2561. eCollection 2020.
OBJECTIVE
To evaluate the efficacy and safety of ureterocalicostomy for long-segment upper ureteral stricture.
METHODS
A total of 13 patients underwent ureterocalicostomy for long-segment upper ureteral stricture, and a long-term follow-up was carried out to observe postoperative results, complications and renal function at 6 months after surgery.
RESULTS
Among the 13 patients undergoing ureterocalicostomy, 12 achieved successful results with surgery. Nine of the 12 received open surgery and 3 patients received laparoscopic surgery. During the perioperative period, 3 patients developed fever while 2 patients had hematuria and irritation in lower urinary tract, and all improved after symptomatic treatment. The 12 patients with successful surgeries achieved remission of hydronephrosis without anastomotic stricture. At 6 months after surgery, the 12 patients had significantly decreased serum creatinine and cystatin C levels and markedly increased estimated glomerular filtration rate, as compared with those before surgery (P<0.05).
CONCLUSION
Ureterocalicostomy is an effective, safe, optional treatment strategy for secondary long-segment upper ureteral stricture.
目的
评估输尿管肾盂吻合术治疗长段上输尿管狭窄的疗效及安全性。
方法
对13例长段上输尿管狭窄患者行输尿管肾盂吻合术，并进行长期随访，观察术后效果、并发症及术后6个月时的肾功能。
结果
13例行输尿管肾盂吻合术的患者中，12例手术成功。12例中9例行开放手术，3例行腹腔镜手术。围手术期，3例患者出现发热，2例患者出现血尿及下尿路刺激症状，经对症治疗后均好转。12例手术成功的患者肾积水缓解，无吻合口狭窄。术后6个月时，12例患者血清肌酐和胱抑素C水平较术前显著降低，估计肾小球滤过率显著升高（P<0.05）。
结论
输尿管肾盂吻合术是继发性长段上输尿管狭窄一种有效、安全的可选治疗策略。
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