Wang Xiang, Zhang Yiming, Zhang Jilong, Li Zhihua, Han Guanpeng, Zhang Lianghao, Li Xinfei, Yang Kunlin, Wang Bing, Zhang Peng, Huang Chen, Liu Jing, Zhu Hongjian, Zhou Liqun, Zhang Kai, Li Xuesong
Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Centre, Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China.
Department of Nursing, Peking University First Hospital, Peking University, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China.
Int Urol Nephrol. 2024 Jun;56(6):1919-1926. doi: 10.1007/s11255-023-03850-4. Epub 2024 Jan 10.
To present our initial experience in the management of multiple ureteral polyps with robotic or laparoscopic ileal ureter replacement (IUR).
Eight consecutive patients diagnosed with multiple ureteral polyps underwent robotic or laparoscopic IUR between July 2019 and November 2022. Unilateral IUR was performed in 5 patients with polyps in the left (n = 3) or right (n = 2) side, and 3 patients with bilateral multiple polyps underwent bilateral IUR. Demographic characteristics, perioperative data and follow-up outcomes were prospectively collected.
A cohort of 5 male and 3 female patients (11 ureters) with a mean age of 32.8 ± 11.3 years were included. Among these patients, 5 presented with recurrent flank pain, 1 had hematuria, and 2 were asymptomatic. Four patients experienced prior failed surgical interventions. The mean length of diseased ureter was 11.9 ± 4.7 cm, with more than 10 cm in eight sides. All procedures were performed successfully. The mean operation time was 319 ± 87.6 min with 3 patients who simultaneously underwent intraoperative ureteroscopy. The mean length of ileal graft was 23.8 ± 5.8 cm. During the mean follow-up of 20.4 ± 12.8 months, one major complication, specifically incision infection, and four minor complications, including urinary infection (n = 3) and metabolic acidosis (n = 1), were observed. All patients presented symptom-free, with improved/stabilized hydronephrosis and no signs of restenosis.
Robotic or laparoscopic IUR is a feasible, safe, and effective surgical option for patients with long ureteral defects caused by multiple polyps.
介绍我们在采用机器人辅助或腹腔镜下回肠代输尿管术（IUR）治疗多发性输尿管息肉方面的初步经验。
2019年7月至2022年11月期间，连续8例被诊断为多发性输尿管息肉的患者接受了机器人辅助或腹腔镜下IUR。5例单侧息肉患者（左侧3例，右侧2例）接受了单侧IUR，3例双侧多发性息肉患者接受了双侧IUR。前瞻性收集了患者的人口统计学特征、围手术期数据和随访结果。
纳入5例男性和3例女性患者（共11条输尿管），平均年龄32.8±11.3岁。其中，5例表现为反复侧腹疼痛，1例有血尿，2例无症状。4例患者既往手术干预失败。病变输尿管的平均长度为11.9±4.7 cm，8侧超过10 cm。所有手术均成功完成。平均手术时间为319±87.6分钟，3例患者同时接受了术中输尿管镜检查。回肠移植物的平均长度为23.8±5.8 cm。在平均20.4±12.8个月的随访期间，观察到1例主要并发症，即切口感染，以及4例次要并发症，包括尿路感染（3例）和代谢性酸中毒（1例）。所有患者均无症状，肾积水改善/稳定，无再狭窄迹象。
对于由多发性息肉引起的长段输尿管缺损患者，机器人辅助或腹腔镜下IUR是一种可行、安全且有效的手术选择。
