Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan.
Department of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan.
Medicina (Kaunas). 2024 Oct 11;60(10):1672. doi: 10.3390/medicina60101672.
Ureteral reconstruction is aimed at maintaining ureteral patency without the need for long-term catheters like ureteral stents or percutaneous nephrostomies. Different surgical strategies are adopted based on the etiology, the location of the injury, and the severity of the injury. We aimed to analyze the parameters that can predict which patients might not be free from further catheterization after reconstruction. This study included patients who underwent ureteral reconstruction from January 2007 to December 2021. The success of ureteral reconstruction was defined as being free from further catheterization after the operation. A total of 184 patients underwent ureteral reconstruction. Malignant disease with ureteral invasion and iatrogenic injuries accounted for 79.9% of the cases. The majority (79.3%) did not have to undergo subsequent interventions. Predictors for a failed result of ureteral reconstruction included a history of radiotherapy (OR = 2.75, = 0.01), chronic kidney disease (CKD) (OR = 3.42, < 0.001), and an upper ureteric location of the injury (OR = 5.68, = 0.042). A history of radiation therapy, an upper third ureteric location of the injury, and CKD were identified as predictors of a failed ureteral reconstruction. Malignant diseases, surgical methods, and repair techniques did not significantly affect the outcome of the operation.
输尿管重建的目的是在无需长期留置输尿管支架或经皮肾造瘘管等导管的情况下保持输尿管通畅。根据病因、损伤部位和严重程度，采用不同的手术策略。我们旨在分析可以预测哪些患者在重建后可能仍需留置导管的参数。
这项研究纳入了 2007 年 1 月至 2021 年 12 月期间接受输尿管重建的患者。输尿管重建成功的定义为术后无需进一步留置导管。
共有 184 例患者接受了输尿管重建。输尿管侵犯的恶性疾病和医源性损伤占病例的 79.9%。大多数（79.3%）患者无需进行后续干预。输尿管重建失败的预测因素包括放疗史（OR=2.75， =0.01）、慢性肾脏病（CKD）（OR=3.42， < 0.001）和输尿管上段损伤（OR=5.68， =0.042）。
放疗史、输尿管上段损伤和 CKD 被确定为输尿管重建失败的预测因素。恶性疾病、手术方法和修复技术对手术结果没有显著影响。
