Hendren W H
J Pediatr Surg. 1980 Dec;15(6):770-86. doi: 10.1016/s0022-3468(80)80280-6.
Reoperative ureteral reimplantation can be difficult if the bladder and ureters are abnormal or the patient has undergone multiple operations. In some cases both ureters can be mobilized and reimplanted again with satisfactory result. That is impossible in others. A useful alternative is long tunnel reimplantation of the better ureter, with psoas hitch, and transureteroureterostomy of the other ureter. If neither ureter is suitable a tapered bowel segment can be used, but this must be done in a manner that prevents reflux. In those patients for whom none of the above choices are possible, cecal augmentation of the bladder offers yet another option, intussuscepting the ileocecal valve to prevent reflux. With these various approaches in the reconstructive armamentarium, urinary diversion should be avoidable in nearly all cases who present after previous failure of ureteral reimplantation.
如果膀胱和输尿管异常或患者已经接受过多次手术，再次进行输尿管再植术可能会很困难。在某些情况下，双侧输尿管都可以游离并再次进行再植，结果令人满意。但在其他情况下则无法做到。一种有效的替代方法是，对情况较好的输尿管进行长隧道再植术并加做腰大肌悬吊，对另一侧输尿管行输尿管-输尿管吻合术。如果双侧输尿管均不适合上述操作，可以使用一段呈锥形的肠段，但必须以防止反流的方式进行。对于那些无法采用上述任何一种选择的患者，膀胱盲肠扩大术提供了另一种选择，即将回盲瓣套叠以防止反流。有了这些重建手段中的各种方法，在几乎所有先前输尿管再植失败后前来就诊的病例中，应该都可以避免尿流改道。
