Strup S E, Bagley D H
Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
J Urol. 1996 Aug;156(2 Pt 1):360-2. doi: 10.1097/00005392-199608000-00007.
We evaluated the technical and long-term success of endoscopic ureteroneocystostomy in patients with complete obstruction of the distal ureter.
We treated 7 patients with complete obstruction at the ureterovesical junction via a combined antegrade and retrograde endoscopic approach (endoscopic ureteroneocystostomy). The etiology of obstruction included ureteroscopy for ureteral calculi in 3 patients and previous resection of bladder tumors or the prostate in 4. Six patients had proximal drainage with a percutaneous nephrostomy catheter at referral. An antegrade approach was used for localization, and a retrograde approach was used for direct visual ureteral meatotomy or ureterotomy with the endoscopic scissors or a cold-knife urethrotome.
Continuity at the ureterovesical junction was restored in all 7 patients, and 6 are currently stricture-free with followup of 14 to 64 months. The sole failure in this series was due to recurrent invasive transitional cell carcinoma.
Endoscopic ureteroneocystostomy is a safe and effective treatment of complete obstruction of the ureterovesical junction.
我们评估了内镜下输尿管膀胱吻合术治疗输尿管远端完全梗阻患者的技术成功率和长期疗效。
我们采用顺行和逆行联合内镜方法（内镜下输尿管膀胱吻合术）治疗了7例输尿管膀胱连接处完全梗阻的患者。梗阻病因包括3例输尿管结石行输尿管镜检查，4例既往有膀胱肿瘤或前列腺切除术。6例患者转诊时经皮肾造瘘管进行近端引流。采用顺行方法进行定位，逆行方法使用内镜剪刀或冷刀尿道切开刀直接直视下进行输尿管肉阜切开术或输尿管切开术。
所有7例患者输尿管膀胱连接处的连续性均得以恢复，6例患者目前无狭窄，随访时间为14至64个月。该系列中唯一的失败病例是由于复发性浸润性移行细胞癌。
内镜下输尿管膀胱吻合术是治疗输尿管膀胱连接处完全梗阻的一种安全有效的方法。
