Schoeneich G, Winter P, Albers P, Fröhlich G, Müller S C
Department of Urology, University of Bonn, Germany.
Scand J Urol Nephrol. 1997 Aug;31(4):383-8. doi: 10.3109/00365599709030625.
The common treatment for patients with extensive damage to the ureter is complete ureteral replacement, combining Boari flap-psoas bladder hitch and downward mobilization of the involved kidney, with complete ideal replacement of the ureter, renal autotransplantation, of elective nephrectomy. Three case reports serve to describe two options of reconstructive treatment for complete ureteral replacement. The operative techniques, their limits, their postoperative results, and the treatment alternatives are discussed with due regard to recent literature. In the case of ileal replacement we have used a very short ileal segment to reduce the absorption surface of the ileal mucosa. Reflux prevention of the ileal segment was performed by creating an invaginated distal ileum nipple which was additionally fixed at the Boari flap by a third stapler row (auto suture TASS) to prevent potential nipple-gliding.
对于输尿管广泛损伤的患者，常见的治疗方法是完全输尿管置换，联合鲍里皮瓣-腰大肌膀胱固定术及受累肾脏向下游离，以实现输尿管的完全理想置换、自体肾移植或选择性肾切除术。三例病例报告用于描述完全输尿管置换的两种重建治疗方案。结合近期文献，对手术技术、其局限性、术后结果及治疗选择进行了讨论。在回肠置换的情况下，我们使用了非常短的回肠段以减少回肠黏膜的吸收面积。通过制作一个内翻的回肠远端乳头来预防回肠段反流，该乳头再通过第三排吻合器（自动缝合TASS）固定在鲍里皮瓣上，以防止乳头潜在的滑动。
