Viville C
J Chir (Paris). 1979 Jan;116(1):55-62.
For ureteral lesions without loss of substance our preferences are, at the level of the lesion, either for end-to-end ureteral suture, or antireflux uretero-vesical reimplantation. For ureteral lesions with loss of substance we prefer the psoas bladder, if the bladder is healthy, large and supple, or inter-ureteral anastomosis if the bladder for some reason (radiotherapy, retracted bladder, small "blocked pelvis") is not available. Synthetic ureteral prosthesis may be a rapid and elegant solution in cancer patients with a limited hope of survival. Guided by these principles, we have repaired 10 ureters : 1 by ureterolysis, 2 by end-to-end suture, 3 by inter-ureteral anastomosis, 4 by antireflux uretero-vesico reimplantation. These 10 repairs gave 9 successes. The only failure (end-to-end ureteral suture) was due to our lack of experience, for in a similar case we would now perform an inter-ureteral anastomosis.
对于未出现实质缺损的输尿管病变，我们倾向于在病变部位行输尿管端端缝合或抗反流输尿管膀胱再植术。对于出现实质缺损的输尿管病变，如果膀胱健康、体积大且柔软，我们更倾向于行腰大肌膀胱固定术；如果因某些原因（放疗、膀胱挛缩、小而“闭锁的盆腔”）无法利用膀胱，则行输尿管间吻合术。对于生存希望有限的癌症患者，合成输尿管假体可能是一种快速且理想的解决方案。遵循这些原则，我们修复了10条输尿管：1例通过输尿管松解术，2例通过端端缝合，3例通过输尿管间吻合术，4例通过抗反流输尿管膀胱再植术。这10次修复有9次成功。唯一的失败病例（输尿管端端缝合）是由于我们缺乏经验，因为在类似病例中我们现在会选择行输尿管间吻合术。
