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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。
Objective To evaluate the effectiveness of ureteral ileal anastomosis in preventing reflux and preventing upper urinary tract infection after controlled urinary diversion. Methods Ten patients with blind ascending colon controllable bladder surgery and neobladder after radical cystectomy were treated with ileum with ileal blind flap as control bladder input and bilateral ureteral submucosal tunneling And ileum anastomosis, follow-up observation of patients with ureteral reflux and upper urinary tract infection. Results Of the 10 cases, the operation was successful and the patients were followed up for 6 to 36 months. No ureteral reflux or upper urinary tract infection occurred. One case had unilateral hydronephrosis, which was caused by anastomotic stenosis. Conclusions Submucosal tunnel ureteral anastomosis is effective in preventing retrograde ureter and upper urinary tract infection after vaginal bypass.