长段输尿管狭窄外科治疗思考:不同自体组织成形术的优劣及微创与开放的抉择  

Reflections on the surgical treatment of long-segment ureteral stricture:advantages and disadvantages of various autologous tissue reconstruction techniques and the choice between minimally invasive and open surgery

作　　者：朱照伟[1] 赵品 张雪培[1] ZHU Zhaowei;ZHAO Pin;ZHANG Xuepei(Department of Urology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院泌尿外科,河南郑州450052

出　　处：《现代泌尿外科杂志》2025年第4期279-283,共5页Journal of Modern Urology

摘　　要：输尿管狭窄是泌尿外科常见疾病,治疗方法主要取决于输尿管狭窄的病因、位置、数目和长度等。长段输尿管狭窄的主要治疗术式包括输尿管腔内治疗、肾盂瓣输尿管成形术、肾下盏输尿管吻合术、颊黏膜输尿管成形术、舌黏膜输尿管成形术、膀胱黏膜输尿管成形术、阑尾代输尿管成形术、膀胱瓣代输尿管成形术和回肠代输尿管成形术。虽然开放手术和腹腔镜手术仍然是常用的治疗方法,但机器人辅助手术因其微创、精确的特点,在临床上应用已越来越多。本文结合最新临床进展及本团队(郑州大学第一附属医院泌尿外科)诊疗经验,着重探讨不同自体组织成形术的优劣及在微创与开放术式之间的抉择,以期从临床实用角度系统介绍长段输尿管狭窄的各种外科治疗新方法和新技术。Ureteral stricture is a common urological condition,whose treatment mainly depends on the etiology,location,number,and length of the stricture.For complex long-segment ureteral stricture,the main surgical procedures include endourological treatment,flap pyeloplasty,ureterocalicostomy,buccal mucosal ureteroplasty,lingual mucosal ureteroplasty,bladder mucosal ureteroplasty,appendiceal ureteroplasty,bladder flap ureteroplasty,and ileal ureter substitution ureteroplasty.Although open and laparoscopic surgeries are still prevalent,robotic surgery is gaining popularity due to its minimally invasive nature and precision.Based on the latest clinical advances and diagnostic and therapeutic experience of our team,we will systematically introduce the new surgical techniques and methods for the treatment of long-segment ureteral stricture from a clinical practical perspective.In addition,we will discuss the advantages and disadvantages of different autologous tissue reconstruction techniques,as well as the choices between minimally invasive and open surgery.

关 键 词：长段输尿管狭窄 腹腔镜手术 机器人辅助手术 尿路重建 自体组织成形术 

分 类 号：R699[医药卫生—泌尿科学]