Department of Urology, Peking University First Hospital, National Urological Cancer Center, Institute of Urology, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China.
Department of Nursing, Peking University First Hospital, National Urological Cancer Center, Institute of Urology, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China.
BMC Surg. 2022 Jul 7;22(1):262. doi: 10.1186/s12893-022-01690-0.
To describe our initial experience with ileal ureteral replacement (IUR) for the management of ureteral avulsion (UA) during ureteroscopic lithotripsy.
Between September 2010 and April 2021, ten patients received ileal ureteral replacement for ureteral avulsion during ureteroscopic lithotripsy. Anterograde urography and computed tomography urography (CTU) were applied to evaluate the lesion. Follow-up was performed with magnetic resonance urography and renal ultrasound as well as clinical assessment of symptoms. We retrospectively analysed the clinical data of ten patients treated with ileal ureteral replacement for the treatment of ureteral avulsion.
Four patients underwent open ileal ureteral replacement, two underwent laparoscopic ileal ureteral replacement, and four underwent robotic-assisted ileal ureteral replacement. The mean operative time (OT) was 310 min (range 191-530). The mean estimated blood loss (EBL) was 193 mL (range 10-1000). The mean length of the ileal graft was 21 cm (range 12-25). The median postoperative hospital time was 13 days (range 7-19). All surgeries were effectively completed, and no case required open conversion in laparoscopic and robotic-assisted surgeries. There was no obvious hydronephrosis according to contrast-enhanced computed tomography 3-dimensional reconstruction images without serious complications or progressive hydronephrosis during a median follow-up duration of 51 months (range 5-131), and the success rate was 100%.
Our initial results and experience showed that ileal ureteral replacement for the management of ureteral avulsion during ureteroscopic lithotripsy is safe and feasible.
描述我们在输尿管镜碎石术中处理输尿管撕脱（UA）时使用回肠替代输尿管（IUR）的初步经验。
2010 年 9 月至 2021 年 4 月，10 例患者在输尿管镜碎石术中因输尿管撕脱而行回肠输尿管替代术。顺行尿路造影和计算机断层尿路造影（CTU）用于评估病变。通过磁共振尿路造影和肾脏超声以及临床症状评估进行随访。我们回顾性分析了 10 例行回肠输尿管替代术治疗输尿管撕脱的患者的临床资料。
4 例行开放回肠输尿管替代术，2 例行腹腔镜回肠输尿管替代术，4 例行机器人辅助回肠输尿管替代术。平均手术时间（OT）为 310 分钟（范围 191-530）。平均估计失血量（EBL）为 193 毫升（范围 10-1000）。回肠移植物的平均长度为 21 厘米（范围 12-25）。中位术后住院时间为 13 天（范围 7-19）。所有手术均有效完成，腹腔镜和机器人辅助手术中无一例需要转为开放手术。根据增强 CT 三维重建图像，无明显肾积水，无严重并发症或进行性肾积水，中位随访时间为 51 个月（范围 5-131），成功率为 100%。
我们的初步结果和经验表明，在输尿管镜碎石术中处理输尿管撕脱时，回肠输尿管替代术是安全可行的。
