Lee Matthew, Lee Ziho, Metro Michael J, Eun Daniel D
Department of Urology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA.
J Endourol Case Rep. 2020 Dec 29;6(4):305-309. doi: 10.1089/cren.2020.0105. eCollection 2020.
Surgical management of long-segment radiation-induced distal ureteral strictures (RIDUS) is challenging. Pelvic radiation can damage the bladder, inhibiting the utilization of typical reconstruction techniques such as a psoas hitch and/or Boari flap. Also, radiation can cause scarring that can make ureterolysis difficult. We present a case series of patients undergoing robotic ureteral bypass surgery with appendiceal graft for management of strictures in this setting. This novel procedure utilizes the patient's appendix as a bypass graft to divert urine away from the strictured portion of ureter and into the bladder; this technique does not require dissection of the strictured ureteral segment. Robotic ureteral bypass surgery can be effective for management of long-segment RIDUS.
长节段放射性输尿管远端狭窄（RIDUS）的手术治疗具有挑战性。盆腔放疗会损伤膀胱，限制了诸如腰大肌悬吊和/或Boari皮瓣等典型重建技术的应用。此外，放疗可导致瘢痕形成，使输尿管松解术变得困难。我们报告了一组在此情况下接受机器人辅助输尿管旁路手术并使用阑尾移植物治疗狭窄的患者病例系列。这种新手术利用患者的阑尾作为旁路移植物，将尿液从输尿管狭窄段引流至膀胱；该技术无需解剖狭窄的输尿管段。机器人辅助输尿管旁路手术对于长节段RIDUS的治疗可能有效。
