输尿管乳头、输尿管膀胱吻合术应用于成人先天性巨输尿管症的体会

目的：：总结输尿管乳头、输尿管膀胱吻合术应用于10例成人先天性巨输尿管症的治疗体会。方法：成人先天性巨输尿管症10例(11侧)中单侧9例,双侧1例,均行输尿管末端外翻成1.5~2 cm乳头后行输尿管膀胱吻合术。结果：随访3个月至10年,10例(11侧)术后肾积水明显减轻或消失,输尿管外形明显改观或恢复正常。结论：成人先天性巨输尿管症的诊断主要靠影像学检查,根据输尿管不同扩张程度行裁剪,在输尿管末端做1.5~2 cm外翻乳头及输尿管膀胱吻合,可以起到有效抗反流和防止吻合口狭窄的作用。

The experience of the application of direct nipple ureteroneocystomy in adults with congenital megaureter

Objective:To summarize the experiences of the application of diret nipple ureteroneocystostomy in 10 adults with congenital megaureter(CM). Methods:Among 10 cases with CM(11 sides),unilateral CM in 9 cases and bilateral CM in 1 case were found. All cases were treated with ureteroneocystostomy after1. 5 to 2. 0 cm evaginating papillae of terminal ureter. Results:All cases were followed up for 3 months to 10 years, the postoperative hydronephrosis in 10 cases ( 11 sides ) improved or disappeared, their ureteral profiles improved or recovered. Conclusions:The imaging examination was the major diagnostic criteria of CM in adult. The ureter was cut back according to different caliber of CM. The 1. 5 to 2. 0 cm evaginating papillae of terminal ureter and ureteroneocystostomy can play an effective role on preventing urine reflux and anastomotic stricture.