[Efficacy of laparoscopic urinary tract reconstruction with intraoperative retrograde ureteroscopy-assisted technique for treatment of complex ureteral stricture]

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2019 Jul 28;44(7):795-800. doi: 10.11817/j.issn.1672-7347.2019.190231.
[Article in Chinese]

Abstract

To investigate the feasibility and clinical effects of the laparoscopic urinary tract reconstruction with intraoperative retrograde ureteroscopy-assisted technique for the treatment of complex ureteral stricture. Methods: The clinical data of 16 patients with complicated ureteral stricture treated by the laparoscopic urinary tract reconstruction with intraoperative retrograde ureteroscopy-assisted technique from February 2016 to June 2018 were retrospectively analyzed. All 16 patients were iatrogenic stenosis. There were 4 cases of severe hydronephrosis in the affected side, 7 cases of moderate hydronephrosis, and 5 cases of mild hydronephrosis. According to the specific location and length of the ureteral stricture, the corresponding surgical method was selected. Results: All patients successfully completed the operation without conversion to open surgery and organ injury. After the operation, the patients were followed up for 8-18 months. The hydronephrosis of all patients was relieved to varying degrees, and no ureteral restenosis occurred. Conclusion: The laparoscopic urinary tract reconstruction with intraoperative retrograde ureteroscopy-assisted technique can accurately locate the stenosis segment, test the anastomosis effect, expand the inflammatory stenosis, and improve the end-to-end anastomosis of the distal ureteral stricture, which is a new and effective technique for the treatment of complex ureteral strictures.

目的:探讨双镜种联合技术处理复杂输尿管狭窄的可行性及临床效果。方法:回顾性分析2016年2月至2018年6月在中南大学湘雅医院运用该技术治疗的16例复杂输尿管狭窄患者的临床资料。16例患者均为医源性狭窄。术前患侧肾脏重度积水4例,中度积水7例,轻度积水5例。根据输尿管狭窄的具体位置及长度选择相应的手术方式。结果:所有患者顺利完成手术,无中转开放手术和脏器损伤。术后随访患者8~18个月,患者患侧肾积水均不同程度减轻,未发生输尿管再狭窄。结论:双镜种联合技术在术中能精准定位狭窄段、检验吻合效果、扩张炎性狭窄、提高远端输尿管狭窄行端-端吻合术的可能性,是一种治疗复杂输尿管狭窄疗效确切且安全可行的新技术。.

MeSH terms

  • Constriction, Pathologic
  • Humans
  • Laparoscopy*
  • Retrospective Studies
  • Ureteral Obstruction* / diagnostic imaging
  • Ureteroscopy