阑尾输尿管成形术治疗右侧输尿管狭窄的初步临床经验:基于8例患者的研究  

Appendiceal onlay flap ureteroplasty for the treatment of right ureteral strictures:initial experience of eight patients

作　　者：肖行远 柴帅帅 董满顺 余秋璇 周袁成 程功 梁超启 何文强 李兵 Xiao Xingyuan;Chai Shuaishuai;Dong Manshun;Yu Qiuxuan;Zhou Yuancheng;Cheng Gong;Liang Chaoqi;He Wenqiang;Li Bing(Department of Urology,Zhongnan Hospital of Wuhan University,Wuhan,Hubei 430071,China;Department of Urology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei 430022,China;Department of Urology,The First Afiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan 450000,China)

机构地区：[1]武汉大学中南医院泌尿外科,湖北武汉430071 [2]华中科技大学同济医学院附属协和医院泌尿外科,湖北武汉430022 [3]河南中医药大学第一附属医院泌尿外科,河南郑州450000

出　　处：《泌尿外科杂志（电子版）》2024年第4期8-12,共5页Journal of Urology for Clinicians(Electronic Version)

摘　　要：目的评估阑尾输尿管成形术修复右侧输尿管狭窄的安全性及临床疗效。方法回顾性分析2021年10月至2024年4月在武汉大学中南医院、华中科技大学同济医学院附属协和医院及河南中医药大学第一附属医院三个临床中心,采用阑尾输尿管成形术修复右侧输尿管狭窄的8例患者的临床资料。记录术中输尿管狭窄长度、阑尾补片长度、手术时间、术中失血量、术后住院时间、术中及术后并发症以及术后恢复等情况,并总结手术策略。结果8例患者中,3例为输尿管中段狭窄,5例为输尿管上段狭窄;输尿管狭窄长度2.5~5 cm,中位狭窄长度4.0 cm。狭窄段输尿管由带系膜阑尾组织修复,阑尾组织取长在3~5 cm。8例患者手术过程均顺利,均无中转开腹发生。中位手术时间为178.0(110~310)min,中位出血量为65.0(40~160)ml,中位住院时间为7.0(6~10)d。术中及术后均无高级别并发症(Clavien-DindoⅢ~Ⅳ)发生。术后中位随访时间22(3~32)个月,8例手术均成功。结论阑尾输尿管成形术修复右侧输尿管狭窄是一种安全、有效的治疗方法,具有手术创伤小,术后恢复快,围手术期并发症少等优点。Objective To evaluate the safety and efficacy of appendiceal onlay flap ureteroplasty for the managment of right ureteral strictures.Methods The data of 8 patients with right ureteral stricture underwent appendiceal onlay flap ureteroplasty from October 2021 to April 2024 in Zhongnan Hospital of Wuhan University,Union Hospital of Tongji Medical College of Huazhong University of Science and Technology,and the First Affiliated Hospital of Henan University of Chinese Medicine were retrospectively analyzed.The length of ureteral stricture,length of appendiceal flap,operation time,intraoperative blood loss,postoperative hospital stay,intraoperative and postoperative complications were analyzed,and the surgical strategy was summarized.Results Of the 8 patients,3 had middle ureteral stricture and 5 had proximal ureteral stricture.The stricture length of 8 patients ranged from 2.5-5 cm,the median length was 4.0 cm.According to the length of ureteral stricture,the mesangial appendix with a length of 3-5 cm was taken,then anastomosed with the ureter.All surgeries were successfully completed without open conversion.The median operative time was178.0(110-310)min,the median blood loss was 65.0(40-160)ml,and the median postoperative hospital stay was 7.0(6-10)d.No high-grade complications(Clavien-DindoⅢ-Ⅳ)occurred in the 8 patients.The median follow-up time was 22(3-32)months,the overall success rate was 100%.Conclusions Appendiceal onlay flap ureteroplasty is a safe and feasible option for managing right ureteral stricture with less trauma,rapid recovery,and less complications.

关 键 词：阑尾输尿管成形术 输尿管狭窄 腹腔镜手术 机器人辅助腹腔镜手术 

分 类 号：R693[医药卫生—泌尿科学]