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输尿管远端单侧损伤的输尿管对端吻合术(作者译)

[Transureteroureterostomy in unilateral distal damage of the ureter (author's transl)].

作者信息

Moncada J, Baán L, Albrecht K F

出版信息

Urologe A. 1978 Sep;17(5):309-12.

PMID:706009
Abstract

Transureteroureterostomy creates an artificial ureter bifidus. In the common branch, the resting pressure is a little bit higher than in its bifurcation and the peristalsis of the bifurcation is never synchronous. That is why an ureteroureteral reflux may be produced by the anastomosis. The ureteroureteral reflux created by a ureteral dyskinesia, however, causes an infection in the recipient kidney only if there is a predisposition to infection or a vesicoureteral reflux in the recipient ureter. A transureteroureterostomy was performed on five female patients suffering from unilateral distal damage of the ureter, four of them after gynecologic operations. One patient had a single kidney right. The damaged ureter was anastomized with the left ureteral stump of the nephrectomied side. In one case, an abscessing retroperioneal urinoma with a serious diffuse peritonitis developed as a direct complication of the operation because of an insufficient suture. On revision, the transplanted ureter had to be drained into the skin. Despite this serious complication, the recipient ureter remained uninjured and the recipient kidney was not damaged. The four other patients had no complications.

摘要

输尿管-输尿管吻合术可形成人工双输尿管。在共同分支处,静息压力略高于其分支处,且分支处的蠕动从不同步。这就是吻合术可能导致输尿管-输尿管反流的原因。然而,由输尿管运动障碍引起的输尿管-输尿管反流,只有在受体肾脏存在感染易感性或受体输尿管存在膀胱输尿管反流时,才会导致受体肾脏感染。对5例患有单侧输尿管远端损伤的女性患者进行了输尿管-输尿管吻合术,其中4例在妇科手术后发病。1例患者右侧为单肾。将受损输尿管与肾切除侧的左输尿管残端吻合。有1例患者,由于缝合不充分,术后直接出现了腹膜后尿囊肿伴严重弥漫性腹膜炎。再次手术时,移植的输尿管不得不引流至皮肤。尽管出现了这种严重并发症,但受体输尿管未受损伤,受体肾脏也未受损。其他4例患者未出现并发症。

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