结肠黏膜尿道成形术治疗复杂性超长段尿道狭窄三例报告  

Colonic mucosa urethroplasty in the treatment of complex long urethral stricture： a three case report with literature review

作　　者：徐庆康[1] 段跃[1] 于田强[1] 陈峰[1] 于永涛[1] 洪翔[1] 徐哲丰[1] 沈伟华[1] 

机构地区：[1]武警浙江省总队医院泌尿外科,嘉兴314000

出　　处：《中华泌尿外科杂志》2011年第10期700-703,共4页Chinese Journal of Urology

摘　　要：目的探讨结肠黏膜尿道成形术治疗复杂性超长段尿道狭窄的应用价值与疗效。方法回顾性分析3例复杂性超长段尿道狭窄患者资料。年龄分别为71、64、48岁，病程分别为3个月、6个月、6年；尿道狭窄段长度分别为13、18、12cm。采用狭窄段尿道切除，截取12～18cm乙状结肠，利用结肠黏膜重建尿道。术后行尿道造影、尿流率及尿道镜随访检查。结果3例于术均获成功，切口愈合良叟，，无尿漏；拔除尿道支架管后患者排尿通畅。术后6周复查最大尿流率分别为16．7、19．6、26．4ml／s；术后3个H球道造影见移植段尿道管径均粗大；术后6个月尿道镜检查2例见结肠黏膜色泽良好，表面光滑，无糜烂，无瘢痕，吻合口愈合好；活检黏膜腺上皮细胞形态末改变，腺体稍萎缩。3例术后分别随访28、16、3个月，排尿通畅。结论结肠黏膜尿道成形术是治疗复杂性趟长段尿道狭窄或闭锁的一种行之有效的方法。Objective To investigate the feasibility of urethral reconstruction with colonic mucosa graft in the treatment of complex long urethral stricture. Methods The clinical data of three cases with complex long urethral stricture were reported and analyzed. Patient ages were 71 , 64 and 48 yrs and the course of disease was three months, six months and six yrs, respectively. The length of urethral stricture was 13, 18 and 12 cm. Removing the narrow urethral segment and intercepting the length from 12 to 18 cm sigmoid colon and stripping colonic mucosa were performed. Urethral reconstruction was done with a free graft of colonic mucosa. Follow-up included urethrography, uroflowmetry, and urethroscopy. Results The urethral reconstructions were completed successfully. The urinary peak flows of the patients were 16.7 ml/s, 19.6 ml/s and 26.4 ml/s at six weeks post operation. Urethrography revealed the graft urethral lumens were bulky three months after the operation. In urethroscopy, the colonic mucosa was found to be of good color and the anastomotic site healed well. Patients were followed-up 28, 16, and three months, respectively, and were all voiding well. Conclusions Colonic mucosa graft urethroplasty is a feasible procedure for the treatment of complex long urethral stricture.

关 键 词：结肠黏膜 尿道狭窄 修复外科手术 

分 类 号：R699[医药卫生—泌尿科学]