Schwaibold H, Friedrich M G, Fernandez S, Conrad S, Huland H
Clinic of Urology, University of Hamburg, Germany.
J Urol. 1998 Sep;160(3 Pt 1):718-20. doi: 10.1016/S0022-5347(01)62766-6.
Ureteroileal stricture after urinary diversion often has deleterious effects on the upper ureteral tract. A common ureteral implantation technique described by Le Duc et al has recently been criticized for a high rate of ureteral stricture. We assessed the rate of upper urinary tract dilatation and deterioration in 60 consecutive patients who underwent continent urinary diversion and ureteroileal anastomosis with a modified Le Duc procedure.
A total of 60 patients underwent continent urinary diversion with an ileal neobladder (Hautmann). Ureteroileal implantation was performed using a modified Le Duc technique. Followup was performed prospectively for a median of 32 months. The clinical end point was postoperative development of upper urinary tract dilatation, or an increase in preoperative dilatation confirmed by excretory urography or furosemide isotope nephrography.
Nonneoplastic deterioration of the upper urinary tract was noted in 4 of 117 renoureteral units (3.4%). No permanent decrease in renal function or increase in pyelonephritic episodes was noted.
The modified Le Duc technique is simple and safe for ureteroileal anastomosis and has a low complication rate.
尿流改道后输尿管回肠吻合口狭窄常对上尿路产生有害影响。Le Duc等人描述的一种常见输尿管植入技术最近因输尿管狭窄发生率高而受到批评。我们评估了60例连续接受可控性尿流改道及采用改良Le Duc手术进行输尿管回肠吻合术患者的上尿路扩张及恶化率。
共有60例患者接受了回肠新膀胱（Hautmann术式）可控性尿流改道。采用改良Le Duc技术进行输尿管回肠植入。前瞻性随访时间中位数为32个月。临床终点为上尿路扩张的术后进展，或经排泄性尿路造影或速尿同位素肾图证实的术前扩张加重。
117个肾输尿管单位中有4个（3.4%）出现上尿路非肿瘤性恶化。未发现肾功能永久性下降或肾盂肾炎发作增加。
改良Le Duc技术用于输尿管回肠吻合术简单安全，并发症发生率低。
