Long-term efficacy of S-shaped bladder muscle flap ureteroplasty for reconstruction of long-segment ureteral avulsion
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摘要: 为了探讨“S”形膀胱瓣输尿管成形术修复长段输尿管撕脱伤的长期疗效。回顾性分析2004年11月—2013年11月东莞市人民医院采用“S”形膀胱瓣输尿管成形术修复的3例长段输尿管撕脱伤患者的临床资料，并统计患者术中手术时间、出血以及术后输尿管形态、肾功能恢复情况。结果显示，术中手术时间255~370 min，平均298 min；出血量200~500 mL，平均333 mL。术后早期存在尿频，随时间延长尿频症状逐渐缓解。膀胱瓣代输尿管形态良好，仅靠近膀胱壁的基底部输尿管稍增粗，中上段输尿管形态良好，无狭窄、肾积水，肾功能稳定。提示“S”形膀胱瓣输尿管成形术经长期随访证实输尿管可恢复并保持良好形态，无肾积水，该术式是长段输尿管撕脱伤修复的理想术式。Abstract: In order to investigate the long-term efficacy of using S-shaped bladder muscle flap ureteroplasty in the treatment of long ureteral segment avulsion, a retrospective analysis was conducted on the clinical data of 3 patients who encountered long ureteral segment avulsion and received S-shaped bladder muscle flap ureteroplasty for reconstruction in Dongguan People's Hospital between November 2004 and November 2013. The intraoperative operation time, bleeding, postoperative ureteral morphology and renal function recovery were also counted. The results showed that the operation time was 255 to 370 min, with an average of 298 min. The bleeding volume was 200 to 500 mL, with an average of 333 mL. The patients had urinary frequency early in the postoperative period, and symptom gradually eased over time. The ureter of the bladder flap was in good shape. Only the distal ureter near the bladder wall was slightly dilated, and the middle and upper ureters had no dilation, no stenosis, no hydronephrosis. These 3 cases'renal function were stable. It is suggested that S-shaped bladder flap ureteroplasty is ideal for the repair of long ureteral avulsion after long-term follow-up. The ureter can be restored and maintained in a good shape with no hydronephrosis.
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Key words:
- ureteral avulsion /
- bladder muscle flap /
- treatment outcome
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表 1 3例患者手术情况及随访结果
项目 病例1 病例2 病例3 手术时间/min 370 270 255 出血量/mL 300 500 200 膀胱瓣长度/cm 12 10 12 随访时间/年 15 12 7 肌酐/(μmol·L-1) 术前 87 92 75 术后(截至随访时) 99 (术后15年) 100 (术后11年) 80 (术后7年) 代输尿管形态 形态良好，无明显扩张 近膀胱段轻度扩张，形态良好 近膀胱段轻度扩张，形态良好 肾积水 无 无 无 输尿管狭窄 无 无 无 并发症情况 无 术后伤口感染 无 
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