经腹股沟皮纹切口输尿管端侧吻合术治疗完全性重肾畸形  

Appplication of end-to-side ureteroureweterostomy via incision of inguinal striae in children with complete duplication anomalies

作　　者：徐卯升[1] 何建华[2] 耿红全[1] 吴燕[1] 徐国锋[1] 林厚维[1] 方晓亮[1] 

机构地区：[1]上海交通大学医学院附属新华医院小儿外科,200092 [2]宁波大学医学院附属宁波市第三医院

出　　处：《中华小儿外科杂志》2012年第3期169-171,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的评价经腹股沟皮纹切口输尿管端侧吻合术治疗儿童完全性重肾畸形的手术疗效。方法从2008年1月至2010年12月间用同侧输尿管端侧吻合术治疗完全性重肾畸形患儿16例（17侧），女14例，男2例，年龄为4个月至12岁。患儿主要表现发热性尿路感染或正常排尿间歇滴尿等症状。经术前影像学检查明确输尿管囊肿8例，膀胱输尿管反流8例，输尿管开口异位5例（1例为双侧）。其中上输尿管囊肿同时存在反流3例，上输尿管囊肿伴下输尿管反流2例，单纯输尿管囊肿3例，单纯下输尿管反流2例，1例上输尿管曾作过再植手术后仍存在反流。结果所有患儿手术过程顺利，平均手术操作时间60min，术后平均住院5d。术后患儿发热性尿路感染或滴尿等症状消失，经术后3～6个月超声、同位素肾图等检查，患肾功能改善，反流消失，肾积水缩小，吻合口无梗阻。结论经腹股沟皮纹切口输尿管端侧吻合术治疗重肾畸形输尿管囊肿、反流及开口异位是一种合适方法。手术操作过程简单、省时，腹股沟皮纹切口美观，此外，手术创伤小，并发症少，缩短了住院时间，还可作为重肾输尿管手术后再次手术的方法。Objective To evaluated the efficacy of the end-to-side reteroureterostomy via inci- sion of inguinal striae in children with complete duplication anomalies. Methods From January 2008 to December 2010, 16 patients with complete duplication anomalies （14 girls and 2 boys） aging 4 months to 12 years underwent ureteroureterostomy via inguinal incision. Most children presented febrile urina- ry tract infections. Before surgery, radiographic examination showed ureterocele in 8 cases, vesi- coureteral reflux in 8 cases and ectopic ureteral orifice in 5 cases （ 1 patient was associated with bilater- al abnormality）. Results The procedure was performed successfully in all patients, the average oper- ating time was 6（I minutes and mean hospital stay was 5 days. The symptoms including febrile urinary tract infections and involuntary discharge of urine eliminated. Continues ultrasonography and radioiso- tope scanning showed reduced hydronephrosis and no anastomotic obstruction and improvement of re- nal function. Conclusions End-to-side reteroureterostomy is an effective procedure for treatment of du- plication anomalies with ureterocele and vesicoureteral reflux, as well as ectopic ureteral orifice. No complicated techniques are needed; furthermore, some advantages can be noted involving minimal invasion, less pain and complications, as well as better cosmetics.

关 键 词：肾 畸形 输尿管疾病 

分 类 号：R699[医药卫生—泌尿科学]