[儿童原发性和继发性巨输尿管。手术矫正的指征及结果]

[Primary and secondary megaureter in children. Indication and results of surgical correction].

作者信息

Walz P H, Hohenfellner R

出版信息

Urologe A. 1983 Nov;22(6):396-400.

Abstract

Fifty-two children with 63 renoureteral units were treated for primary megaureter (p.m.) and 62 children with 102 renoureteral units for secondary megaureter (s.m.) due to infravesical obstruction. The changing concepts of diagnosis and therapy in 3 periods influenced both the indication for ureteroneocystostomy (p.m.: 79%, 63%, 58%; s.m.: 71%, 30%, 31%) and the rate of good results of operation (p.m.: 63%, 80%, 76%; s.m.: 44%, 78%, 81%), the criteria for good results being no infection, no reflux, no dilatation. Extensive diagnostic studies are necessary to avoid false indications with consequent poor therapeutic results. In cases of incidentally diagnosed primary megaureter without symptoms conservative treatment or "watchful waiting" is justified.

摘要

52例患有63个肾盂输尿管单位的儿童因原发性巨输尿管（p.m.）接受治疗，62例患有102个肾盂输尿管单位的儿童因膀胱下梗阻导致继发性巨输尿管（s.m.）接受治疗。3个时期诊断和治疗观念的变化影响了输尿管膀胱吻合术的指征（p.m.：79%、63%、58%；s.m.：71%、30%、31%）以及手术良好效果的比例（p.m.：63%、80%、76%；s.m.：44%、78%、81%），良好效果的标准为无感染、无反流、无扩张。需要进行广泛的诊断研究以避免错误指征，从而导致治疗效果不佳。对于偶然诊断出的无症状原发性巨输尿管病例，保守治疗或“观察等待”是合理的。