Manjunath Darshan A, Radhakrishna Veerabhadra, Vepakomma Deepti
Department of General Surgery, McGann Hospital, Shivamogga Institute of Medical Sciences Shivamogga, Karnataka, India.
Department of Pediatric Surgery, Bangalore Medical College and Research Institute Bengaluru, India.
Am J Clin Exp Urol. 2021 Apr 15;9(2):163-169. eCollection 2021.
Transureteroureterostomy (TUU) is a urinary reconstructive procedure seldom used but has a role when conventional reconstructive techniques are not possible. However, the concern is whether it places the opposite, non-diseased ureter and kidney at risk. Hence a retrospective study was conducted to evaluate indications, methods, and outcomes of transureteroureterostomy in children. The study included seven children who underwent TUU between January 2011 and December 2015. The mean age of the study group was 4.5 ± 2.9 years. Six (86%) patients were males. Two patients had primary bladder diverticulum, two posterior urethral valves, two cases of vesico-ureteric reflux, and one had a persistent urogenital sinus. All patients presented with recurrent urinary tract infections. Three (43%) patients had bladder outlet obstruction. Four (57%) patients underwent left to right TUU with right ureteric reimplantation. Two (29%) patients underwent an additional procedure. No complications were found. The key to a good outcome in TUU is case selection. Surgical technique plays a very important role in ensuring good long-term outcome without compromising the normal moiety.
输尿管-输尿管吻合术（TUU）是一种很少使用的尿路重建手术，但在无法采用传统重建技术时具有一定作用。然而，人们担心它是否会使对侧未患病的输尿管和肾脏处于危险之中。因此，开展了一项回顾性研究，以评估儿童输尿管-输尿管吻合术的适应证、方法和结果。该研究纳入了2011年1月至2015年12月期间接受TUU手术的7名儿童。研究组的平均年龄为4.5±2.9岁。6名（86%）患者为男性。2例患者患有原发性膀胱憩室，2例患有后尿道瓣膜，2例患有膀胱输尿管反流，1例患有持续性泌尿生殖窦。所有患者均有复发性尿路感染。3名（43%）患者存在膀胱出口梗阻。4名（57%）患者接受了从左到右的TUU并进行了右侧输尿管再植术。2名（29%）患者接受了额外的手术。未发现并发症。TUU取得良好效果的关键在于病例选择。手术技术在确保良好的长期效果且不影响正常部分方面起着非常重要的作用。
