Puppo P, Ricciotti G, Bozzo W, Pezzica C, Geddo D, Perachino M
Department of Urology, S. Corona Hospital, Pietra Ligure (SV), Italy.
Eur Urol. 1995;28(4):328-33. doi: 10.1159/000475076.
Since January 1993, 9 patients with bilateral ureteral obstruction due to advanced pelvic cancers underwent videoendosurgical cutaneous ureterostomy. Five patients had prostate cancer, 3 had uterine cancer and only 1 bladder cancer. In 5 cases a bilateral laparoscopic transperitoneal procedure was performed. In 4 cases a retroperitoneal laparoscopic technique was adopted and only in 1 out of these 4 cases the procedure was done bilaterally. All the procedures were done under general anesthesia. The procedure was accomplished in all the cases without any intraoperative complication; the operative time ranged between 35 and 130 min. Postoperative pain was rather insignificant and did not require additional medication. Postdiversion hospital stay ranged from 3 to 11 days according to the general condition of the patients. The mean follow-up is 10.8 months. In conclusion, retroperitoneal laparoscopic cutaneous ureterostomy seems to be a reasonable alternative to percutaneous nephrostomy in case of bilateral ureteral obstruction due to advanced prostate or uterine cancer, provided that the clinical condition of the patient allows general anesthesia.
自1993年1月起，9例因晚期盆腔癌导致双侧输尿管梗阻的患者接受了视频内镜下皮肤输尿管造口术。其中5例为前列腺癌患者，3例为子宫癌患者，仅1例为膀胱癌患者。5例患者采用了双侧腹腔镜经腹手术。4例患者采用了腹膜后腹腔镜技术，且这4例中仅1例进行了双侧手术。所有手术均在全身麻醉下进行。所有病例手术均顺利完成，无任何术中并发症；手术时间为35至130分钟。术后疼痛相当轻微，无需额外用药。根据患者的一般情况，术后改道住院时间为3至11天。平均随访时间为10.8个月。总之，对于因晚期前列腺癌或子宫癌导致双侧输尿管梗阻的患者，若患者临床状况允许全身麻醉，腹膜后腹腔镜皮肤输尿管造口术似乎是经皮肾造瘘术的合理替代方案。
