Fukuda Tetsuo, Tajirika Hironao, Ishikawa Tatsuro, Matsuzaki Junichi
The Department of Urology, Ohguchi Higashi General Hospital.
Hinyokika Kiyo. 2023 Sep;69(9):239-242. doi: 10.14989/ActaUrolJap_69_9_239.
We retrospectively evaluated the safety and effectiveness of retrograde ureteroscopy via ileal conduit construction. Between January 2014 and December 2021, 5 patients (8 procedures) with ileal conduit construction received retrograde ureteroscopic lithotripsy with a 11/13 Fr ureteral access sheath. At postoperative 1 month, a plain computed tomography (CT) and kidney, ureter, and bladder X-ray (KUB) were performed to assess stone fragmentation and hydronephrosis. According to postoperative imaging, stone-free was defined as residual fragments of 4 mm or less on KUB and 2 mm or less on CT. The mean stone size was 11 mm (6-13 mm). The mean stone volume was 1. 51 ml (0.33-2.56 ml). The mean operative time was 91 min (60-133 min). SFR was 100% on KUB and 87.5% on CT. One procedure (12.5%) resulted in a postoperative fever greater than 38.5℃. There were no complications of grade III or higher according to the modified Clavien-Dindo classification. No exacerbation of hydronephrosis was observed on CT. Retrograde ureteroscopy with a ureteral access sheath was found to be effective for urolithiasis in patients with ileal conduit.
我们回顾性评估了经回肠代膀胱构建逆行输尿管镜检查的安全性和有效性。2014年1月至2021年12月期间,5例(8次手术)接受回肠代膀胱构建的患者使用11/13 Fr输尿管通路鞘进行了逆行输尿管镜碎石术。术后1个月,进行了腹部平扫计算机断层扫描(CT)和肾脏、输尿管及膀胱X线检查(KUB),以评估结石破碎情况和肾积水情况。根据术后影像学检查,结石清除定义为KUB上残留碎片≤4 mm,CT上残留碎片≤2 mm。平均结石大小为11 mm(6 - 13 mm)。平均结石体积为1.51 ml(0.33 - 2.56 ml)。平均手术时间为91分钟(60 - 133分钟)。KUB上结石清除率为100%,CT上为87.5%。1例手术(12.5%)术后发热超过38.5℃。根据改良Clavien - Dindo分类法,无III级或更高等级的并发症。CT上未观察到肾积水加重。发现使用输尿管通路鞘的逆行输尿管镜检查对回肠代膀胱患者的尿路结石有效。