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Clinical benefits of tubeless umbilical cutaneous ureterostomy

机译:无管脐带皮肤输尿管造口术的临床益处

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Introduction: We assess a novel technique of tubeless bilateral cutaneous ureterostomy, with a single umbilical stoma, for bladder cancer patients with short ureters after cystectomy. The benefit of cutaneous ureterostomy is equal to other incontinent urinary diversions, when the tubeless procedure is successfully achieved. This simple technique makes it easy to monitor the upper urinary tract (UUT) and is beneficial to patients with a high risk of UUT recurrence. Methods: This old and new surgical technique was used to perform total cystectomy and urinary diversion on three patients with bladder cancer at a high risk of UUT recurrence. Results: Two men and one woman (mean age: 73 years) underwent this surgery and the mean follow-up period was 8.3 years. The surgical approaches were laparotomy (n = 2) and laparoscopy (n = 1). One case developed para-stomal erosion, whereas another developed ureteral stenosis requiring catheter reinsertion. Although postoperative hydronephrosis was observed in all cases, the mean preoperative and postoperative serum creatinine levels were 0.70 and 0.76, respectively. UUT recurrence was not observed during the follow-up period. Conclusion: This tubeless umbilical cutaneous ureterostomy procedure greatly improves the outcome of urinary diversion for cancer patients with short ureters at a high risk of UUT recurrence. The benefits are equivalent to other urinary diversions when the tubeless procedure is successfully achieved.
机译:简介:我们评估了一种具有单脐造口的无管双侧皮肤输尿管造口术的新技术,用于膀胱切除术后输尿管短的膀胱癌患者。成功完成无管手术后,皮肤输尿管造口术的好处与其他失禁性尿道改道相同。这种简单的技术使监测上尿路(UUT)变得容易,并且对UUT复发风险高的患者有益。方法:使用这种新旧外科手术技术对3例UUT复发风险较高的膀胱癌患者进行全膀胱切除术和尿流改道。结果:2名男性和1名女性(平均年龄:73岁)接受了该手术,平均随访时间为8.3年。手术方法为开腹手术(n = 2)和腹腔镜检查(n = 1)。一例发生了口旁糜烂,而另一例发生了输尿管狭窄,需要重新插入导管。尽管在所有病例中均观察到术后肾积水,但术前和术后血清肌酐的平均水平分别为0.70和0.76。在随访期间未观察到UUT复发。结论:这种无管脐带皮肤输尿管造口术极大地改善了患有输尿管短且高UUT复发风险的癌症患者尿流改道的效果。当成功完成无管手术时,其益处等同于其他尿流改道。

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