输尿管回肠吻合术在可控性尿流改道中的应用

目的 评价输尿管回肠吻合术在可控性尿流改道术后抗返流及防止上尿路感染中的效果。方法 根治性膀胱切除术后行去带盲升结肠可控膀胱术和新膀胱术的患者10例，采用带回盲瓣的回肠段作为可控性膀胱的输入襻，双侧输尿管黏膜下隧道法与回肠吻合，随访观察患者术后输尿管返流及上尿路感染情况等。结果 10例手术顺利，术后随访6～36个月，均未发生输尿管返流或上尿路感染，1例发生单侧肾积水，为吻合口狭窄所致。结论 黏膜下隧道法输尿管回肠吻合术预防去带盲升结肠可控性尿流改道术后输尿管返流及上尿路感染效果良好。

Submucosal tunnel ureteroileostomy in detenia ceacal-colon continent urinary diversion using ileovalvular segment as afferent loop

Objective To evaluate the usefulness of the submucosal tunnel ureteroileostomy using ileovalvular segment as afferent loop in preventing ureteral refluxes and upper urinary tract infection in detenia ceacal-colon continent urinary diversion. Methods Ten patients underwent submucosal tunnel ureteroileostomy in detenia ceacal-colon continent reservior and detenia coloneobladder and the follow up for ureteral reflux and upper urinary tract infection was carried out from 1998 to 2001. Results The patients were followed up for 6 to 36 months.No evidence of ureteral reflux and upper urinary tract infection was observed.Unilateral hydronephrosis was found in one patient caused by the ureteroileal anastomotic stricture. Conclusions Submucosal tunnel ureteroileostomy is an effective fashion for detenia ceacal-colon continent urinary diversion in preventing the postoperative complications of ureteral reflux and upper urinary tract infection.