目的：总结回肠代输尿管术治疗孤立肾并输尿管癌的经验，为临床工作提供借鉴和指导。方法分析1例功能性孤立肾合并输尿管癌患者接受回肠代输尿管术治疗的临床资料，结合文献进行分析讨论。结果术中切除全段右侧输尿管及袖状切除输尿管入口处膀胱壁后切取25 cm 回肠替代右侧输尿管。术后夹闭肾造瘘管后早期出现轻度肾功能不全，2周后恢复正常。术后出现代谢性酸中毒，积极予以口服碳酸氢钠后得以纠正。术后1个月行右侧上尿路顺行造影示回肠输尿管通畅，各吻合口无狭窄，肾盂轻度扩张。术后随访6个月，患者排尿正常，肾功能正常，一般情况良好。未见肿瘤复发征象。结论对于孤立肾合并输尿管癌患者回肠代输尿管术是一种可供选择的手术方法，能够去除肿瘤、恢复尿路的连续性、避免永久性肾造瘘、改善生活质量。%Objective To summarize the experience of ileal replacement of ureter in the treatment of solitary kidney combined with ure-teral carcinoma,and to provide reference and guidance for clinical work.Methods We analyzed the clinical data of 1 case of ileal re-placement with ureteral function in patients with functional solitary kidney combined with ureteral carcinoma,together with literature a-nalysis.Results Surgical resection of the right ureter and the sleeve section of the ureter at the entrance of the bladder wall were per-formed.A 25 cm ileum was cut to replace the right ureter.During the early period of fistulization after surgery,there was mild renal dys-function,which returned to normal after 2 weeks.Metabolic acidosis occurred after the surgery,and was cured with oral sodium bicar-bonate.One month after the surgery,ileal ureter was confirmed by right upper ureterography with no stenosis of the anastomosis and a slight dilation of the renal pelvis.The patient was followed up for 6 months,which showed that the patient was in good condition with normal urination and no signs of tumor recurrence.Conclusions Ileal ureter replacement surgery is an alternative surgical method for solitary kidney combined with ureteral cancer patients,which can remove the tumor,restore the continuity of the urinary tract,avoid per-manent renal fistula and improve the quality of life.
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