肾切除术和部分输尿管切除术后因膀胱输尿管反流导致的远端输尿管残端反流的自然病史。
Natural history of refluxing distal ureteral stumps after nephrectomy and partial ureterectomy for vesicoureteral reflux.
作者信息
Cain M P, Pope J C, Casale A J, Adams M C, Keating M A, Rink R C
机构信息
Department of Urology, James Whitcomb Riley Hospital for Children, Indiana University Medical Center, Indianapolis, USA.
出版信息
J Urol. 1998 Sep;160(3 Pt 2):1026-7. doi: 10.1097/00005392-199809020-00017.
PURPOSE
We evaluated the natural history of refluxing distal ureteral stumps after nephrectomy and partial ureterectomy.
MATERIALS AND METHODS
Between 1985 to 1996, 38 patients a mean age of 37 months underwent nephrectomy and partial ureterectomy for reflux into a nonfunctioning kidney. The diagnosis included primary reflux in 23 patients, reflux associated with posterior urethral valves in 10 and ipsilateral ureterocele in 5. Mean followup was 45 months.
RESULTS
Only 1 patient with an ipsilateral ureterocele and 1 with contralateral reflux (5%) had symptomatic infections during postoperative followup, and each underwent a secondary procedure to remove the ureteral stump. No patient with only primary unilateral reflux required surgery for the refluxing stump.
CONCLUSIONS
Because of the low risk of morbidity associated with a refluxing ureteral stump, we recommend nephrectomy and proximal ureterectomy in patients with reflux into a nonfunctioning kidney.
目的
我们评估了肾切除及部分输尿管切除术后远端输尿管残端反流的自然病程。
材料与方法
1985年至1996年间，38例平均年龄37个月的患者因无功能肾反流接受了肾切除及部分输尿管切除术。诊断包括23例原发性反流、10例与后尿道瓣膜相关的反流以及5例同侧输尿管囊肿。平均随访时间为45个月。
结果
术后随访期间，仅1例同侧输尿管囊肿患者和1例对侧反流患者（5%）出现有症状的感染，且均接受了二次手术以切除输尿管残端。仅原发性单侧反流的患者中，无一人因反流性残端需要手术。
结论
由于输尿管残端反流相关的发病风险较低，我们建议对无功能肾反流患者行肾切除及近端输尿管切除术。
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