膀胱三角区粘膜沟内固定法行抗返流输尿管-膀胱吻合术

目的　针对尿路疾患需行输尿管膀胱吻合术 ,同时合并膀胱粘膜慢性病理改变的患者 ,探索一种抗返流效果理想的手术方法。方法　采用膀胱三角区粘膜沟内固定法对 31例患者行输尿管膀胱吻合术 ,其中 16例为二次手术 ,11例伴有严重的膀胱粘膜慢性病理改变 ,包括小梁形成、假性憩室和慢性炎症。结果　 90 %的患者 3mo时IVP检查未见肾积水加重 ,排尿期膀胱造影未见返流征象。 2 5例随访 1～ 3a显示手术效果满意。结论　当膀胱粘膜存在慢性病理改变时 ,膀胱三角区粘膜沟内固定法是一种理想的输尿管膀胱吻合术。

Internal fixation of transtrigonal mucosal groove for anti-reflux ureterocystostomosis

Objective The purpose of this study was to consider a kind of new antireflux operation in patients with urinary tract diseases combined with bladder epithelium chronic pathologic change . Method By internal fixation of transtrigonal mucosal groove, vasicoureteral anastomosis had been performed in 31 cases from July 1994 to march 1997.Among of them, 16 patients were operated for the second time and 11 patients with chronic pathological mucosal change including trabeculation ,sacculation and chronic inflammation . Results IVP shown no hydro-nephrosis becoming worse in 90% of the patients on third month. Voiding cysto-graphy shown no cyst-uretereflux. In followed up for 1～3 years, 25 patients had a good result. Conclution For patient with bladder epithelium chronic pathologic change , this operation is a good choice.