关键词: 回肠, 吻合术, 外科, 输尿管疾病, 医源性疾病

Abstract:

Objective：To investigate the efficacy of ileal ureteric replacement in the treatment of iatrogenic long segment ureteric injuries. Methods: The hospital records of 9 cases with iatrogenic long segment ureteric injuries during Aug. 2010 to Sept. 2014 treated with ileal ureteric replacement were retrospectively reviewed and followed-up postoperatively. The patients included 3 males and 6 females with a median age of 40 years. The length of injury segment was 13-25 cm (median 20 cm). The etiology of the iatrogenic injury was urological surgery (n=6), gynecological surgery (n=2) and general surgery (n=1), respectively. The ureter stent was removed in 1-2 month postoperatively in all the 9 cases. Results: All the operations were successful. The operation time was 203-394 min, with the average of (278.1±68.8) min. The bleeding volume was 10-1 000 mL, with the median of 200 mL. The mean length of hospital stay was (16.8±7.5) days. Four minor complications (Grade Ⅰ-Ⅱ) developed, including 3 ileus (33.3%) and 1 proximal anastomotic leakage (11.1%). The median followup time was 11 months, serum creatinine decreased or remained stable in 8 patients (88.9%). Three patients (33.3%) developed mild hydronephrosis and shorttime urinary tract infection was seen in 1 patient (11.1%). Metabolic acidosis was not detected during the followup. Conclusion: Ileal ureteric replacement is a safe and effective method in patients with complex or difficult iatrogenic long segment ureteric injuries.

Key words: Ileum, Anastomosis, surgical, Ureteral diseases, Latrogenic disease