遠端輸尿管重建: 萬芳醫院六年經驗
賴宗豪1、許軒豪1、溫玉清1,2*、林克勳1、林雍偉1、蕭志豪1、李良明1,2
1臺北醫學大學-北醫·萬芳醫院-泌尿科，2臺北醫學大學 泌尿學科
Distal ureteral reconstruction: six years’ experience in wan fang hospital
Chung-Howe Lai1, Syuan-Hao Syu1, Yu-Ching Wen 1, 2＊, Ke-Hsun Lin1, Yung-Wei Lin 1,2, Chi-Hao Hsiao 1, Liang-Ming Lee1
1 Department of Urology, Wan Fang Hospital, Taipei Medical University
2 Department of Urology, School of Medicine, College of Medicine, Taipei Medical University
Purpose: To assess the outcomes of patients who have had distal ureteral reconstruction in a single center.
Materials and Methods: We reviewed the patients who underwent distal ureteral reconstruction from January 2010 to December 2015. The preoperative and postoperative estimated glomerular filtration rate (eGFR) and causes of the underlying ureteral disorder were collected. The complications of different operative methods were compared.
Results: We reviewed 21 patients with mean age of 60.6 (37-88) year-old. The mean follow-up time was 22.2 (1.7-60.3) months. Of these 21 patients, 15 had reconstruction with Boari flap and 6 had distal ureteroureterostomy. The most common cause was related to colorectal surgery; with the next in line being gynecological surgery. All patients had preserved renal function. Comparing the complication rate of ureteral stenosis, the ureteroureterostomy group showed significantly higher rate than the Boari flap group (p = 0.022).
Conclusion: Both Boari flap repair and ureteroureterostomy are safe for patients requiring distal ureteral reconstruction surgery. Boari flap repair can prevent complications such as ureteral stenosis in long term follow-up.