下腔静脉后输尿管的诊断与治疗(附10例报告)

目的 提高下腔静脉后输尿管的诊治水平。方法 行输尿管造影（RU）或磁共振尿路造影（MRU）等检查，特征性影像学表现为输尿管呈反J形或S形。治疗采用输尿管切断复位矫正术，术中切除下腔静脉后有病变的输尿管2－3cm，无张力吻合输尿管。结果 10例患者术前均明确诊断。术后3－6个月复查症状消失，肾积水均有不同程度减轻，吻合口无狭窄。结论 IVU和RU是诊断下腔静脉后输尿管的首选方法，输尿管切断复位矫正术是治疗此病较好的手术方式。

The diagnosis and treatment of retrocaval ureter (report of 10 cases)

Objective　To study the diagnosis and treatm ent of retrocaval ureter.　Mathods　10 cases of retrocava l ureter were reported. The diagnosis of this disease depends on imaging examin ations, such as intravenous urography (IVU), retrograde ureterography (RU) or MR urography (MRU).Surgical operation was used to treat this disease. The compress ed retrocaval portion of ureter was resected and end-to-end anastomosis was pe rformed anterior to the vena cava in all the 10 cases.　Results　All the 10 cases were correctly diagnosed preoperatively. IVU and RU or MRU showed right hydronephrosis with reversed “J shaped”or “S shaped” ureter . B-ultrasound and IVU revealed improvement of hydronephrosis and no ureter ste n osis was observed postoperatively.　Conclutions　IVU and R U were the f irst choice to diagnose retrocaval ureter. Segmental resection of the ureter wi th end-to-end stomosis is the ideal procedure for the treatment of this dise ase.