Department of Urology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
Comput Math Methods Med. 2021 Mar 17;2021:6668415. doi: 10.1155/2021/6668415. eCollection 2021.
Relieving obstruction and protecting renal function are the main therapeutic purposes of obstructive uropathy which often involve surgical treatment, and the ureter catheter is one of the surgical instruments commonly used in surgery. We aimed to explore the innovative use of a ureter catheter in the surgery of obstructive uropathy.
We used a ureteral catheter to innovate the surgical procedure of the most common causes of obstructive uropathy: ureteral calculi and stricture, establishing an internal circulation system (ICS), proposing a three-step dilatation method, and reviewing their effects on patients. Furthermore, we introduced a simple real-time intrapelvic pressure measurement device to monitor intrarenal pressure during operation.
Postoperative laboratory examination showed that blood CRP, leukocyte neutrophil level, changes in the hemoglobin, urine occult blood, and positive rate of urine culture in the ICS group are significantly lower than those in the control group, corresponding to a lower incidence of bleeding and infection-related complications clinically. A three-month follow-up revealed 1/3 rate of ureteral stricture in the ICS group comparing to the control. We applied the three-step dilatation in patients with severe stenosis in which the balloon could not pass; the overall effective rate was 90.9%. The pressure of the renal pelvis was displayed on the monitor in real time. The surgeon could estimate the degree of filling of the renal pelvis and adjust the intake volume through the data.
The innovative application of ureteral catheters in the operation of obstructive uropathy can realize the real-time monitor of intraoperative renal pelvis pressure, reduce the incidence of lithotripsy postoperative complications, and expand the indications of balloon dilatation in ureteral stricture, which has certain clinical significance.
解除梗阻、保护肾功能是治疗梗阻性尿路疾病的主要目的，其中常涉及手术治疗，输尿管导管是手术中常用的一种手术器械。我们旨在探讨输尿管导管在梗阻性尿路疾病手术中的创新应用。
我们使用输尿管导管对最常见的梗阻性尿路疾病的手术方法进行创新：输尿管结石和狭窄，建立一个内部循环系统（ICS），提出三步扩张法，并回顾其对患者的效果。此外，我们引入了一种简单的实时肾盂内压力测量装置，以监测术中肾内压力。
术后实验室检查显示，ICS 组的血 CRP、白细胞中性粒细胞水平、血红蛋白变化、尿潜血和尿培养阳性率均明显低于对照组，对应临床出血和感染相关并发症的发生率较低。三个月的随访显示，ICS 组的输尿管狭窄发生率为 1/3，而对照组为 1/3。我们将三步扩张法应用于严重狭窄的患者，其中球囊无法通过，整体有效率为 90.9%。肾盂压力实时显示在监视器上。外科医生可以通过数据估计肾盂的充盈程度并调整输入量。
输尿管导管在梗阻性尿路疾病手术中的创新应用可以实现术中肾盂压力的实时监测，降低碎石术后并发症的发生率，并扩大输尿管狭窄球囊扩张的适应证，具有一定的临床意义。
