Kristjánsson A, Engellau L, Willner J, Månsson W
Department of Urology, University Hospital, Lund, Sweden.
Scand J Urol Nephrol. 1997 Oct;31(5):425-9. doi: 10.3109/00365599709030635.
In the present study the incidence of reflux, stricture formation and changes in glomerular filtration rate in patients with the submucosal tunnel or the Camey-Le Duc technique of ureteric implantation into the caecum/detubularized right colon used for continent cutaneous diversion/orthotopic bladder substitution was investigated. Reflux was found in two renal units and ureterointestinal stenosis occurred in five renal units after submucosal tunnel ureteric implantation. After Camey-Le Duc ureteric implantation, one renal unit showed reflux and none had stenosis of the ureterointestinal anastomosis during follow-up. Mean glomerular filtration rate (ml/min/1.73 m2) fell from 98 to 85 in the submucosal tunnel group and from 88 to 81 in the Camey-Le Duc group after mean follow-ups of 9 and 5 years, respectively. Both methods of ureteric implantation in this study were effective in preventing reflux, and renal function was well preserved in both groups. The absence of ureterointestinal strictures in the Camey-Le Duc group is encouraging and indicates that this is a reliable method for reflux prevention.
在本研究中，对采用黏膜下隧道或卡米-勒迪克技术将输尿管植入盲肠/去管化右半结肠用于可控性皮肤造口尿流改道/原位膀胱替代的患者的反流发生率、狭窄形成情况以及肾小球滤过率的变化进行了调查。黏膜下隧道输尿管植入术后，在两个肾单位中发现了反流，五个肾单位出现了输尿管肠狭窄。卡米-勒迪克输尿管植入术后，一个肾单位出现反流，随访期间无输尿管肠吻合口狭窄。黏膜下隧道组平均随访9年后，肾小球滤过率（毫升/分钟/1.73平方米）从98降至85；卡米-勒迪克组平均随访5年后，肾小球滤过率从88降至81。本研究中的两种输尿管植入方法在预防反流方面均有效，两组的肾功能均得到了良好的保留。卡米-勒迪克组未出现输尿管肠狭窄，这令人鼓舞，表明这是一种可靠的预防反流的方法。
