回肠代双侧输尿管联合“N”形膀胱扩大成形术治疗宫颈癌放疗后膀胱挛缩输尿管狭窄1例报告  

A case of bladder contracture and ureteral stenosis after radiotherapy for cervical cancer treated with bilateral ileal ureter substitution combined with"N-shaped"bladder augmentation and plasty

作　　者：张楷乐[1] 司捷旻[1] 李松 方文卓 王营[1] 杨冉星[1] 周晓辉[1] 胡晓勇[1] 傅强[1] Zhang Kaile;Si Jiemin;Li Song;Fang Wenzhuo;Wang Ying;Yang Ranxing;Zhou Xiaohui;Hu Xiaoyong;Fu Qiang(Department of Urology,Shanghai Sixth People's Hospital,Shanghai Oriental Institute of Urological Repair and Reconstruction,Shanghai 200233,China)

机构地区：[1]上海市第六人民医院泌尿外科、上海东方泌尿修复重建研究所,上海200233

出　　处：《中华泌尿外科杂志》2024年第9期711-713,共3页Chinese Journal of Urology

摘　　要：宫颈癌放疗后的输尿管狭窄和膀胱挛缩是泌尿外科的难题。回肠输尿管成形联合回肠膀胱扩大术是改善患者肾积水和排尿功能的潜在方法,然而该手术过程较为复杂,手术风险大,术中、术后并发症较多,影响了该术式的推广应用。本中心采用回肠代双侧输尿管联合回肠“N”形膀胱扩大成形术治疗1例。术后2周拔除单J管,术后3周拔除导尿管,患者自主控尿,排尿通畅。术后3、18个月随访,双侧输尿管无积水,肾功能正常,膀胱容量明显扩大。Ureteral stenosis and bladder contracture after radiotherapy for cervical cancer are challenging issues in urology.Ileal ureteroplasty combined with ileal bladder augmentation is a potential method to improve hydronephrosis and voiding function of patients,however,the surgical procedure is complex,with high surgical risks and numerous intraoperative and postoperative complications,which have hindered the widespread application of this surgical technique.This article introduces our hospital's experience through a typical surgical case.During the surgery,ileal substitution for bilateral ureters was performed in combination with ileal"N-shaped"augmentation.Two weeks after the surgery,the single-J stent was removed,and the urinary catheter was removed three weeks after the surgery.The patient achieved voluntary urination control with smooth voiding.Follow-up examinations at 3 months and 18 months postoperatively showed no hydronephrosis in the bilateral ureters,normal renal function,and a significantly expanded bladder capacity.

关 键 词：膀胱挛缩 输尿管狭窄 肠代输尿管 膀胱扩大术 宫颈癌 放疗 

分 类 号：R737.33[医药卫生—肿瘤]