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使用GelPOINT Path穿刺接入鞘成功修复骨盆骨折尿道损伤所致的尿道直肠瘘

Successful Urethrorectal Fistula Repair Using GelPOINT Path Anal Access Sheath in Pelvic Fracture Urethral Injury.

作者信息

Tanaka Wataru, Kanematsu Akihiro, Beppu Naohito, Kawai Kenichiro, Yoshioka Shinpei, Shimatani Kimihiro, Yanagi Toeki, Kakibuchi Masao, Ikeda Masataka, Yamamoto Shingo

机构信息

Department of Urology Hyogo Medical University Hyogo Japan.

Division of Colorectal Surgery, Department of Gastrointenstinal Surgery Hyogo Medical University Hyogo Japan.

出版信息

IJU Case Rep. 2025 Apr 27;8(4):319-321. doi: 10.1002/iju5.70028. eCollection 2025 Jul.

DOI:10.1002/iju5.70028
PMID:40607482
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12212956/
Abstract

INTRODUCTION

We present a case of rectourethral fistula complicating urethral trauma, successfully treated using a transanal exposure device.

CASE PRESENTATION

A male in his twenties was referred to us with a pelvic fracture urethral injury. Preoperative imaging revealed an urethrorectal fistula. Excision and primary anastomosis urethroplasty was performed transperineally. The fistula was primarily closed transanally via GelPOINT Path access sheath, which provided wide access to the anal canal. The closure was reinforced perineally, with a gracilis muscle flap interposition. Postoperative urethral patency was excellent without recurrent fistula.

CONCLUSION

This method could be an effective alternative for urethrorectal fistula repair.

摘要

引言

我们报告一例因尿道外伤并发直肠尿道瘘的病例，该病例通过经肛门暴露装置成功治疗。

病例介绍

一名二十多岁的男性因骨盆骨折合并尿道损伤被转诊至我院。术前影像学检查发现尿道直肠瘘。经会阴行尿道切除及一期吻合尿道成形术。通过GelPOINT Path接入鞘经肛门初步闭合瘘口，该鞘为肛管提供了广泛的入路。经会阴用股薄肌瓣插入加强闭合。术后尿道通畅良好，无瘘复发。

结论

该方法可能是修复尿道直肠瘘的一种有效替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3e0/12212956/be64dfba203e/IJU5-8-319-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3e0/12212956/66b4ddaf5418/IJU5-8-319-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3e0/12212956/137dab8cf670/IJU5-8-319-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3e0/12212956/be64dfba203e/IJU5-8-319-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3e0/12212956/66b4ddaf5418/IJU5-8-319-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3e0/12212956/137dab8cf670/IJU5-8-319-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3e0/12212956/be64dfba203e/IJU5-8-319-g001.jpg

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本文引用的文献

1
Rectourethral Fistula Repair Using Robotic Transanal Minimally Invasive Surgery (TAMIS) Approach.经肛门机器人微创外科（TAMIS）入路修复直肠阴道瘘。
Urology. 2021 Aug;154:338. doi: 10.1016/j.urology.2021.05.027. Epub 2021 May 30.
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Results of the York Mason Procedure with and without Concomitant Graciloplasty to Treat Iatrogenic Rectourethral Fistulas.行 York Mason 手术联合或不联合 Graciloplasty 治疗医源性直肠尿道瘘的结果。
Eur Urol Focus. 2020 Jul 15;6(4):762-769. doi: 10.1016/j.euf.2019.07.005. Epub 2019 Aug 8.
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Use of the GelPoint Path access channel for rectal trauma.
GelPoint Path入路通道在直肠创伤中的应用。
ANZ J Surg. 2019 Dec;89(12):E589-E590. doi: 10.1111/ans.14997. Epub 2019 Jan 28.
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Transanal minimally invasive surgery for local excision of early rectal tumor.
Asian J Endosc Surg. 2018 May;11(2):182-184. doi: 10.1111/ases.12431.
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Complex posterior urethral injury.复杂性后尿道损伤
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Acquired rectourethral fistulas in adults: a systematic review of surgical repair techniques and outcomes.成人获得性直肠尿道瘘：手术修复技术和结果的系统评价。
Dis Colon Rectum. 2013 Mar;56(3):374-83. doi: 10.1097/DCR.0b013e318274dc87.