[1]刘华章 石秦林 林涛** 吴盛德 何大维 李旭良 魏光辉.经尿道膀胱镜下切开术治疗小儿输尿管囊肿[J].中国微创外科杂志,2017,17(3):213-215.
　Liu Huazhang,Shi Qinlin,Lin Tao,et al.Transurethral Cystoscopic Incision for the Treatment of Ureterocele in Children[J].Chinese Journal of Minimally Invasive Surgery,2017,17(3):213-215.
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经尿道膀胱镜下切开术治疗小儿输尿管囊肿()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
17
期数:
2017年3期
页码:
213-215
栏目:
临床研究
出版日期:
2017-06-20

文章信息/Info

Title:
Transurethral Cystoscopic Incision for the Treatment of Ureterocele in Children
作者:
刘华章 石秦林 林涛** 吴盛德 何大维 李旭良 魏光辉
重庆医科大学附属儿童医院泌尿外科儿童发育疾病研究教育部重点实验室儿科学重庆市重点实验室儿童发育重大疾病国家国际科技合作基地,重庆400014
Author(s):
Liu Huazhang;  Shi Qinlin;  Lin Tao;  et al.
Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
关键词:
输尿管囊肿; 内镜
Keywords:
Ureterocele; Endoscopy
文献标志码:
A
摘要:
目的探讨经尿道膀胱镜下切开术治疗小儿输尿管囊肿的效果。方法2007年2月~2015年4月对42例小儿输尿管囊肿行经尿道膀胱镜下切开术,单纯型：在囊肿前壁下方，膀胱颈部上方，做一横行切口；异位型：纵行切开位于尿道内的囊肿，切口自囊肿远端经膀胱颈延伸至膀胱内。结果39例一次性切开减压成功，3例术后1年内二次切开减压成功。8例术前存在膀胱输尿管反流（Ⅱ~Ⅲ度7例，Ⅳ度1例），3例因尿路感染未控制行输尿管再植术，术后尿路感染控制；余5例随访1~3年，4例反流消失，1例仍存在反流（Ⅱ度），口服小剂量抗生素无尿路感染发生。5例术后出现患侧囊肿相连肾/半肾段膀胱输尿管反流（Ⅱ~Ⅲ度4例，Ⅳ度1例），1例（Ⅳ度）因尿路感染未控制行输尿管再植术，术后尿路感染控制；余4例术后随访1~4年，3例反流消失，1例仍存在反流（Ⅱ度），口服小剂量抗生素无尿路感染发生。余29例术后随访6个月~5年，平均1年10个月，临床症状均控制，无反流发生，未行重建手术治疗。结论经尿道膀胱镜下切开术简单、微创，不仅可用于解除尿路梗阻，而且可降低复杂尿路手术实施的可能性。
Abstract:
ObjectiveTo investigate the clinical efficacy of transurethral cystoscopic incision for ureterocele in children. MethodsA retrospective study was reviewed on 42 children diagnosed with ureterocele who underwent transurethral cystoscopic incision in our hospital from February 2007 to April 2015. For simple ureteroceles, a transverse incision was made below the anterior wall of the ureterocele and above the bladder neck. For ectopic ureteroceles, a longitudinal incision was extended from the distal ureterocele through bladder neck to the inside of bladder.ResultsThe decompression was successfully carried out at one stage in 39 cases, while the other 3 cases required a second decompression 1 year following the primary procedure. Among 8 patients who had initial vesicoureteral reflux (grade Ⅱ-Ⅲ in 7 cases and grade Ⅳ in 1 case), 3 patients required ureteric reimplantation because of urinary tract infection and the infection was controlled after surgery, while the remaining 5 patients were followed up for 1-3 years with the reflux resolved spontaneously in 4 cases and the reflux (grade Ⅱ) remained in 1 patient whose urine showed no infection by taking small doses of oral antibiotics. Five patients developed vesicoureteral reflux to the kidney/upper moiety kidney (grade Ⅱ-Ⅲ in 4 cases and grade Ⅳ in 1 case), among which ureteric reimplantation was conducted in 1 case (grade Ⅳ) because of urinary tract infection and the infection was controlled after surgery, and the remaining 4 cases were followed up for 1-4 years, with the reflux resolved spontaneously in 3 cases and the reflux (grade Ⅱ) remained in 1 case whose urine showed no infection by taking small doses of oral antibiotics. The rest of 29 patients were followed up for 6 months to 5 years (mean, 1 year 10 months) and the clinical symptoms had been controlled, with no vesicoureteral reflux occurred. All the 29 patients didn’t need urinary tract reconstruction.ConclusionsTransurethral cystoscopic incision is a simple procedure with less damage. It can be used not only to relieve urinary tract obstruction, but also to reduce the possibility of complicated urinary tract reconstruction operation.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目：国家临床重点专科建设资助项目（国卫办医函［2013］544）**通讯作者，E-mail：lintao272@aliyun.com
更新日期/Last Update: 2017-06-20