Pohl J B, Meyer-Jürgens U B, Leusmann D B
Urologische Klinik, Westfälische Wilhelms-Universität Münster, FRG.
Scanning Microsc. 1987 Dec;1(4):1887-92.
In an experimental study on 8 canine ureters, end-to-end anastomoses were performed after segmental resection between 9 and 13 cm, using two different surgical techniques. After 3 months of observation the three-dimensional structure of the anastomosis and the surrounding areas was investigated by ureteroscopy and scanning electron microscopy. 3 types could be differentiated by the morphologic features of the ureteral lumen: normal width, segmental stricture, and circumferential stricture. The results offer a plausible explanation for the occasional discrepancy between histologic findings of relatively normal lumen width, and functional disorders apparently reflecting ureteral stenosis. They further support that excellent functional and morphologic reconstruction can be achieved even under the extreme conditions of 13 cm segmental resection with obligatory anastomosis under tension. The findings connected with dilatations observed distal to the anastomotic site appear rather contradictory, their interpretation is difficult.
在一项对8条犬输尿管的实验研究中，采用两种不同的手术技术，在9至13厘米的节段性切除后进行端端吻合。观察3个月后，通过输尿管镜检查和扫描电子显微镜研究吻合口及其周围区域的三维结构。根据输尿管管腔的形态特征可区分出3种类型：管腔宽度正常、节段性狭窄和环形狭窄。这些结果为相对正常管腔宽度的组织学发现与明显反映输尿管狭窄的功能障碍之间偶尔出现的差异提供了合理的解释。它们进一步支持，即使在13厘米节段性切除且吻合口必然处于张力状态的极端条件下，也能实现良好的功能和形态重建。与吻合口远端观察到的扩张相关的发现似乎相当矛盾，难以解释。
