輸尿管及對側輸尿管吻合術之長期手術結果: 單ㄧ醫學中心經驗
陳韋辰1、李建儀1、洪晟鈞1、王樹吉1、王賢祥1、林嘉彥1、陳卷書1、楊晨洸1、程千里1、蘇重光2、游智欽3、裘坤元1
臺中榮總外科部泌尿外科1；林新醫院泌尿科2；臺北慈濟醫院泌尿科3
Transureteroureterostomy Long-Term Surgical
Outcome - A Single Institute Experirence
Wei-Cheng Chen1, Jian‐Ri Li1, Sheng‐Chun Hung1, Shu‐Chi Wang1, Shian‐Shiang Wang1, Chia‐Yen Lin1, Chuan‐Su Chen1, Cheng‐Kuang Yang1, Chen‐Li Cheng1, Chung-Kuang Su2, Chih-Chin Yu3, Kun‐Yuan Chiu1
Divisions of Urology1, Department of Surgery, Taichung Veteran General Hospital, Taichung, Taiwan; Lin Shin Hospital2, Taipei Tzu Chi Hospital3
Purpose: Transurterureterostomy is a useful reconstruction strategy for restoring collecting system patency. In this retrospective study, we reviewed and organized the cases who received transureteroureterostomy in our institute from various urological conditions, and discussed the long-term surgical outcome.
Materials and Methods: From 2010/01/01 to 2018/12/31, there were 34 patients receiving transureteroureterostomy for reconstruction. We compared the patient demographic data, etiology, the functional outcome, complications and additional treatment when performed.
Results: In all the 34 cases, 4 was performed due to iatrogenic ureteral injury, 10 from obstruction, and another 19 from invasion. Among the ureters invaded by tumor, 9 was colorectal cancer, 6 was urotherlial carcinoma. For the reconstruction sides, 21 was left to right, 12 right to left, and one graft ureter to right ureter. The operative methods, 33 in open method, exploring from previous wound, 1 was done with laparoscopy. Renal function was improved in most patients (27 cases, 79,4%).
Conclusions: Transureteroureterostomy is a safe and feasible reconstruction technique which restore collecting system patency and improve previous compromised renal function. Stricture and urolithiasis happened in few cases, which can be managed by minimal invasive procedures.