原位膀胱术后10年单侧输尿管皮肤瘘1例报告并文献复习  

Unilateral ureterocutaneous fistula after orthotopic ileal neobladder:a case report and literature review

作　　者：涂真 杨雪松[3] 邓显忠[3] TU Zhen;YANG Xuesong;DENG Xianzhong(Department of Urology,Yuechi County People’s Hospital,Guang an 638300;Institute of Morphology,North Sichuan Medical College,Nanchong 637000;Department of Urology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]四川省岳池县人民医院泌尿外科,四川广安638300 [2]四川省川北医学院形态研究所,四川南充637000 [3]四川省川北医学院附属医院泌尿外科,四川南充637000

出　　处：《现代泌尿外科杂志》2024年第5期450-452,共3页Journal of Modern Urology

基　　金：四川省基层卫生事业发展研究中心课题项目(No.SWFZ23-Y-55)。

摘　　要：目的分析临床收治的患者资料并文献复习,探讨原位膀胱术后出现输尿管皮肤瘘的诊治要点。方法分析岳池县人民医院泌尿外科收治的1例原位膀胱术后10年出现输尿管皮肤瘘患者的资料。结果患者77岁,男性,因膀胱癌行腹腔镜下全膀胱切除+回肠原位新膀胱术后10年出现输尿管皮肤瘘,表现为原手术切口有液体渗出,曾误诊为腹壁窦道,因右肾无功能,切除右肾后瘘道愈合。结论输尿管皮肤瘘多见于肾移植以及上尿路结石、黄色肉芽肿肾炎等疾病术后,经瘘道造影可确诊该病。术中应积极排除漏尿,若发现尿路损伤可一期修补。Objective The main points of diagnosis and treatment of ureterocutaneous fistula after in situ bladder operation were discussed based on clinical data and literature.Methods This report presents the data of a patient who developed a ureterocutaneous fistula 10 years after an in situ bladder procedure at Yuechi County People’s Hospital.Results A 77-year-old male underwent laparoscopic cystectomy with orthotopic ileal neobladder for bladder cancer.The case manifested as fluid leakage from the original surgical incision,initially misdiagnosed as abdominal wall sinus.After right nephrectomy due to non-functional kidney,the fistula healed.Conclusion Ureterocutaneous fistulas are commonly associated with kidney transplantation and postoperative complications of upper urinary tract such as calculi and xanthogranulomatous pyelonephritis.Fistulography can be conclusive for this condition.Prompt identification and repair of urinary tract injuries are crucial.

关 键 词：膀胱肿瘤 膀胱切除术 正位膀胱替代术 输尿管皮肤瘘 肾积水 

分 类 号：R699.5[医药卫生—泌尿科学]