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
肖行远 1柴帅帅 1董满顺 1余秋璇 1周袁成 1程功 2梁超启 1何文强 3李兵1
作者信息
- 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
- 折叠
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-Dindo Ⅲ～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.
Abstract
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 was 178.0(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-Dindo Ⅲ-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Key words
Appendiceal onlay flap ureteroplasty/Ureteral strictures/Laparoscopic surgery/Robot-assisted laparoscopic surgery引用本文复制引用
出版年
2024
NETL
NSTL
万方数据