Huisman T K, Kaplan G W, Brock W A, Packer M G
Department of Urology, Naval Hospital, San Diego, California 92134-5000.
J Urol. 1987 Nov;138(5):1207-10. doi: 10.1016/s0022-5347(17)43551-8.
We reviewed our 15-year experience with pyeloureterostomy and ureteroureterostomy in 25 children with ureteral duplication. Pyeloureterostomy was performed in 5 patients, including 4 with reflux and 1 with upper pole obstruction. The results were good in 4 and in 1 patient postoperative anastomotic obstruction developed. Ipsilateral ureteroureterostomy was performed in 20 patients, including 8 with reflux into 1 or both ipsilateral ureters, 7 with obstructed ectopic upper pole ureters without ureterocele, 4 with ectopic ureteroceles and 1 with incomplete ureteral duplication and obstruction of the common distal ureteral segment. At followup, which ranged from 3 months to 6 years, 17 patients had good postoperative results as demonstrated by improved upper tract drainage and absence of reflux. Of 6 patients who underwent simultaneous ipsilateral ureteral reimplantation at the time of ureteroureterostomy postoperative reflux was noted in 1, necessitating a second procedure. Ureteral stumps were left in 13 patients. Postoperative urinary infection occurred in only 3 of these patients, all as single episodes and 2 associated with persistent contralateral reflux. Significant luminal disparity at the time of ureteroureterostomy was noted in 18 patients and did not adversely affect results.
我们回顾了25例重复输尿管患儿行肾盂输尿管吻合术和输尿管输尿管吻合术的15年经验。5例患儿接受了肾盂输尿管吻合术，其中4例合并反流，1例合并上极梗阻。4例效果良好，1例术后出现吻合口梗阻。20例患儿接受了同侧输尿管输尿管吻合术，其中8例反流至同侧1条或2条输尿管，7例梗阻性异位上极输尿管无输尿管囊肿，4例异位输尿管囊肿，1例不完全性输尿管重复畸形合并共同远端输尿管段梗阻。随访时间为3个月至6年，17例患儿术后效果良好，表现为上尿路引流改善且无反流。6例在输尿管输尿管吻合术时同时行同侧输尿管再植术的患儿中，1例术后出现反流，需再次手术。13例患儿保留了输尿管残端。这些患儿中仅3例发生术后尿路感染，均为单次发作，2例与持续性对侧反流有关。18例患儿在输尿管输尿管吻合术时存在明显的管腔差异，但未对结果产生不利影响。
