Baba S, Oya M, Miyahara M, Deguchi N, Tazaki H
Department of Urology, Keio University, School of Medicine, Tokyo, Japan.
Urology. 1994 Jul;44(1):122-6. doi: 10.1016/s0090-4295(94)80023-5.
Laparoscopic transposition and reanastomosis of a circumcaval ureter were performed in a 52-year-old man with right flank pain. A preoperative perfusion pressure study revealed abnormally high intrapelvic pressure. Under laparoscopy, the renal pelvis was divided above the ureteropelvic junction and the ureter was relocated from behind the vena cava. A 5 cm segment of redundant ureter containing the postcaval segment was resected and the ureteral end and renal pelvis were reapproximated with interrupted sutures by intracorporeal knot typing. The postoperative convalescence was uneventful, not necessitating the administration of analgesics. The patient resumed full activities 3 weeks later. The intravenous urogram and renogram obtained 2 months after the operation revealed remarkable improvement in the ureteral obstruction.
对一名52岁右侧腰痛男性患者进行了腹腔镜下腔静脉后输尿管转位及再吻合术。术前灌注压力研究显示肾盂内压力异常升高。在腹腔镜下，于输尿管肾盂交界处上方将肾盂离断，输尿管从腔静脉后方移位。切除包含腔静脉后段的5cm冗余输尿管段，通过体内打结法用间断缝线将输尿管末端与肾盂重新对合。术后恢复顺利，无需使用镇痛药。患者3周后恢复正常活动。术后2个月的静脉肾盂造影和肾图显示输尿管梗阻有显著改善。
