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Modified laparoscopic intravesical nonrefluxing ureteral reimplantation with psoas hitch using a submucosal tunneling

机译:改良腹腔镜膀胱不回流输尿管加腰大肌结膜移植术

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摘要

We aimed to study the safety and efficacy of the cystoscopy-assisted nonrefluxing ureteral reimplantation technique using submucosal tunneling during laparoscopic ureteroneocystostomy (UNC) with a psoas hitch in patients with distal ureter stricture after gynecologic surgery. We reviewed six female patients who underwent gynecological surgeries. All patients showed persistent postoperative distal ureter stricture or obstruction. These patients underwent laparoscopic nonrefluxing UNC with a psoas hitch using a submucosal tunneling technique combined with cystoscopy at our institute. They had corrective surgery at an average of 13.3 weeks after ureteral injury. The short-term success was confirmed either by voiding cystourethrography (VCU) or by diuretic isotope renal scan (MAG-3) conducted 3 months after the operation. None of the patients showed evidence of postoperative stricture at the reimplanted site and reflux on either MAG-3 renal scan or VCU. None of the patients showed major or minor complications during follow-up. It is safe and feasible to perform the laparoscopic nonrefluxing UNC with a psoas hitch using a submucosal tunneling technique combined with cystoscopy for ureteral stricture.
机译:我们旨在研究在妇科手术后输尿管狭窄的患者中,在腹腔镜输尿管膀胱造口术(UNC)伴腰大肌结的情况下使用粘膜下隧道术进行膀胱镜辅助的非回流输尿管再植技术的安全性和有效性。我们审查了六名接受妇科手术的女性患者。所有患者术后均出现持续性输尿管远端狭窄或阻塞。这些患者在我们的研究所使用粘膜下隧道技术与膀胱镜检查相结合的方式进行了腰大肌结扎术的腹腔镜不返流UNC。他们在输尿管损伤后平均进行了13.3周的矫正手术。术后3个月行膀胱尿道造影(VCU)排空或利尿同位素肾脏扫描(MAG-3)证实了短期成功。没有患者在再植入部位显示术后狭窄的迹象,在MAG-3肾扫描或VCU上也没有反流的迹象。随访期间均无患者出现严重或轻微并发症。使用粘膜下穿刺技术结合膀胱镜对输尿管狭窄进行腰大肌结栓腹腔镜不返流UNC是安全可行的。

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