回肠代输尿管术一期修复医源性长段输尿管损伤的疗效分析  

Efficacy analysis of primary repair of iatrogrnic long-segment ureteral injury by ileal ureteral replacement

作　　者：李俊涛 叶雷 吴坚坚 郭强 尧冰 赖华健 莫嘉辉 王德娟 邱剑光 Li Juntao;Ye Lei;Wu Jianjian;Guo Qiang;Yao Bing;Lai Huajian;Mo Jiahui;Wang Dejuan;Qiu Jianguang(Department of Urology,the Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655,China)

机构地区：[1]中山大学附属第六医院泌尿外科,广州510655

出　　处：《中华腔镜泌尿外科杂志（电子版）》2022年第5期423-426,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：广东省自然科学基金-面上项目(2019A1515010386)。

摘　　要：目的探讨回肠代输尿管术在腹盆腔手术所致医源性长段输尿管损伤的疗效。方法回顾性分析2017年9月至2021年2月中山大学附属第六医院10例回肠代输尿管术患者的病例资料。术后对所有患者进行门诊及电话随访,了解术后并发症及肾功能情况,采用Clavien-Dindo并发症分级系统对术后并发症进行分级,分析所得结果。结果10例患者的手术均顺利完成,均为开腹手术,平均住院时间(30±12)d,平均替代肠管长度(14.5±1.6)cm,中位随访时间6.5(2,14)个月,术前、拔管后1个月血肌酐值分别为(116±100)μmol/L、(101±53)μmol/L。5例患者出现术后并发症,均为Clavien-Dindo I~Ⅱ级。结论一期回肠代输尿管术处理术中长段医源性输尿管损伤是一种有效的治疗手段,治疗效果满意。Objective To investigate the efficacy of ileal ureteral replacement in the treatement of iatrogenic long-segment ureteral injury during abdominal or pelvic surgery.Methods The clinical data of 10 patients with ileal ureteral replacement in the Sixth Affliated Hospital of Sun Yat-sen University from September 2017 to February 2021 were retrospectively analyzed.All patients were followed up by clinic and telephone after surgery to get the information of postoperative complications and renal function.Clavien-dindo complication classification system was used to grade postoperative complications and analyze the results.Results All 10 cases were successfully operated in open surgery.The mean length of hospitalization was(30+12)days,the mean length of the replacement ileum was(14.5±1.6)cm,the median follow-up time was 6.5(2,14)months,and the serum creatinine value before surgery and after extubation was(116±100)μmol/L,(101±53)μmol/L.Postoperative complications(Grade I-II)were occurred in 5 patients.Conclusion Primary ileal ureteral replacement is an effective treatment for intraoperative iatrogenic long-segment ureteral injury,with satisfactory therapeutic effect.

关 键 词：回肠代输尿管术 医源性 输尿管损伤 

分 类 号：R699.4[医药卫生—泌尿科学]