目的 探讨不同类型输尿管先天性畸形的最优治疗手段.方法 回顾性分析119例输尿管先天性畸形的治疗,其中开放手术85例(其中11例为双侧病变,其他为单侧病变,共计96例次),输尿管成形术58例,端端吻合术3例,输尿管膀胱再植术25例,输尿管囊肿扩张切除1例,巨输尿管裁剪术9例；内镜下手术15例,其中输尿管扩张6例,输尿管囊性扩张裁剪4例、电切5例.结果 119例患者中111例(93.3％)获得随访,随访时间3个月～11年,其中开放手术97例次,成功92例,失败5例.输尿管成形、输尿管膀胱再植术一次性成功率分别为94.3％ (55/58)和93.3％( 24/25)；输尿管端端吻合、囊性扩张裁剪及电切后均获满意效果；巨输尿管裁剪术后有94.1％ (8/9)效果满意.结论 开放手术目前仍是输尿管先天性畸形的主要治疗手段.腔内镜下治疗具有简单、痛苦小等优点,更适用于输尿管出口囊肿治疗,而对于输尿管狭窄治疗的远期效果不理想.%Objective To investigate the best strategy for management of congenital ureter malformations.Methods One hundred and nineteen cases of congenital ureter malformations were analyzed,in which 85 cases were treated with open surgery (Bilateral lesions in 12 cases,the others were unilateral lesions).58 cases had angioplasty ureter,3 cases had end-to-end anasto-mosis,25 cases had ureterovesical replantation,1 case had ureterocele excision,9 cases of giant ureters had surgery cutting and 15 cases were managed by endoscopic surgery,including 6 cases of ureteral expansion,4 cases of ureterocele cutting,5 cases of electricity cutting ureterocele.Results One-time success rate of the treatment of ureter forming and bladder-ureter replantation was respectively 94.3％ and 93.3％ ; treatment with end-to-end ureter anastomosis and the cut and electricity cutting of the cyst was good; 9 cases were satisfied after Giant ureteral clipping(94.1％ ).Conclusions The open surgery is still the primary method to treat the congenital ureter malformations.Endoscopic treatment with the advantage of a minimal invasive seems optimistic for the treatment of ureter outlet's cyst,but the long-term effects of endoscopic treatment for ureteral stricture are not satisfied.
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