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输尿管膀胱镜

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Laparoscope combined with cystoscope for the treatment of upper tract transitional cell carcinoma is safe and effective.

对肾盂癌和中、上段输尿管癌采取腹腔镜联合膀胱镜行肾、输尿管全长切除可闭合输尿管末端,避免术中肿瘤种植,是一种安全有效的手术方式。

Cystoscope and retrograde pyeloureterography are the basic diagnostic means.Ureteroscopy can obviously elevate the diagnostic rate.

膀胱镜,逆行肾盂输尿管造影是诊断本病最基本的方法,输尿管镜能明显提高本病的确诊率。

Methods 25 patients with upper tract transitional cell carcinoma underwent resection under Laparoscope and cystoscope. Integrity and the detent of ureterostoma was detected after the operation.

对25例肾盂肿瘤或中上段输尿管肿瘤的患者采取腹腔镜联合膀胱镜行肾、输尿管全长切除,术后检查手术标本的完整性,并行输尿管内压力测定,对输尿管口的封闭性进行评估。

Methods Clinical data of 51 patients with PRF were retrospectively analyzed. Among the 51 cases, 12 were treated with the ureteroscopic holmium: YAG laser lithotripsy and stenting after it, 29 with retrograde intubation under cystoscope, 10 with retrograde intubation under cystoscope and percutaneous nephrostomy.

对51例不同梗阻原因致肾后性急性肾功能衰竭的患者,采用急诊输尿管镜下钬激光碎石并置管引流(12例)、膀胱镜下逆行双J管插管(29例)、膀胱镜下逆行双J管插管联合经皮肾穿刺造瘘引流(10例)解除梗阻,回顾性分析其治疗效果。

Antegrade percutaneous access was obtained by X-ray perspective or B-type ultrasound guidance. A combination pneumatic and ultrasonic lithotrity was used to disintegrate and remove stone under direct vision.

患侧输尿管于膀胱镜下逆行留置5F输尿管导管,推注生理盐水以充盈肾盂。X射线透视或B超引导下穿刺目标肾盏,建立皮肾通道,肾镜下采用气压弹道联合超声碎石术。

Results: 15 cases of patients were diagnosed as primary ureteral carcinoma by B-ultrasonography, intravenous pyelogram, cystoscopy and retrograde urography, CT, MRI, ureteroscopy before operation. all of the patients were proved to be transitional cell carcinoma by pathological examination after operation.

结果:术前15例患者经B超、静脉肾盂造影、膀胱镜及逆行肾盂输尿管造影、输尿管镜等检查诊断为原发性检尿管癌。18例患者均经术后病理检查确诊为原发性输尿管癌。

Results Eight cases all cured, thereinto, one stitches removed, one ureter membrane repaired, by cystoscopic reversing ureter, two diversion by embedding D-J pipe, one ureter anastomosed, one kidney cutted, two bladder repaired.

结果 8例均治愈,其中拆除缝线1例,行输尿管浆肌层修补1例,经膀胱镜逆行输尿管植入D-J管引流2例,输尿管端端吻合1例,肾切除1例,膀胱修补2例。

Methods A retrospective analysis was performed in 14 cases of urinary obstruction among 1090 cases of transplanted kidney in the year 2000-2006, including 9 cases of vesicoureteral anastomotic stricture, 6 of whom received a second vesicoureteral anastomosis, one had infection surrounding the renal graft and ureter end necrosis, two ureteral anastomosis with bladder muscle flap, and one stenostomia aerocyst distention under ureteroscope.

回顾总结2000-2006年我院1090例肾移植患者中的14例移植后上尿路梗阻患者,其中输尿管膀胱吻合口狭窄9例,6例行膀胱输尿管二次吻合手术,1例移植肾周感染输尿管末段坏死采用移植肾近端新鲜存活输尿管与自体输尿管吻合,1例采用膀胱肌瓣代移植输尿管,1例采用输尿管镜下气囊扩张后放置双J管。

Diagnostic ureteroscopy, including dilatation of ureterovesical junction and cystoscopy

诊断性输尿管镜检,包括输尿管膀胱接合处,扩张术及膀胱镜术

Results one case with bladder injury and one case with ureteral injury recoveried after open operation,one case with bladder injury and one case with ureteral injury were cured through laparoscopic gynecological surgery,one case with bladder injury and two cases with uroschesis were cured after expectant treatment,one case with ureteral injury recoveried after being treated with ureteroneocystostomy.

结果 1例膀胱损伤及1例输尿管损伤术中转开放术治愈;1例膀胱损伤及1例输尿管损伤经术中镜下缝合伤口治愈;1例膀胱损伤经留置尿管保守治疗治愈;2例尿潴留均经保守治疗治愈;1例输尿管损伤经术后行输尿管膀胱再植术治愈。

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