[1]胡超 段灵星 鲁雄兵**.电切镜联合亚甲蓝在腺性膀胱炎中寻找困难输尿管开口中的应用[J].中国微创外科杂志,2022,01(8):667-670.
　Hu Chao,Duan Lingxing,Lu Xiongbing..Application of Resectoscope Combined With Methylene Blue for Finding Difficult Ureteral Orifice in Cystitis Glandularis[J].Chinese Journal of Minimally Invasive Surgery,2022,01(8):667-670.
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电切镜联合亚甲蓝在腺性膀胱炎中寻找困难输尿管开口中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年8期
页码:
667-670
栏目:
经验交流
出版日期:
2022-11-25

文章信息/Info

Title:
Application of Resectoscope Combined With Methylene Blue for Finding Difficult Ureteral Orifice in Cystitis Glandularis
作者:
胡超 段灵星 鲁雄兵**
(南昌大学第二附属医院泌尿外科，南昌330000)
Author(s):
Hu Chao;  Duan Lingxing;  Lu Xiongbing.
Department of Urology, Second Affiliated Hospital of Nanchang University, Nanchang 330000, China
关键词:
腺性膀胱炎; 输尿管口; 亚甲蓝; 双J管; 电切镜
Keywords:
Cystitis glandularis; Ureteral orifice; Methylene blue; DoubleJ stent; Resectoscope
文献标志码:
B
摘要:
目的探讨电切镜联合亚甲蓝在腺性膀胱炎(cystitis glandularis，CG)中寻找困难输尿管开口的价值。方法2019年 6月～2021年9月我们对13例CG合并困难输尿管开口膀胱内病变进行标准切除，然后薄层电切目标输尿管开口区，初步明确输尿管开口。膀胱灌注0.01%亚甲蓝溶液，在亚甲蓝视野中观察输尿管口喷尿情况。5 min后用生理盐水冲洗膀胱，找到外翻未染色的壁内段输尿管黏膜，插入导丝。更换输尿管镜确认输尿管腔，在导丝引导下置入双J管。结果13例(23侧)在亚甲蓝染色指引下成功置入双J管。手术时间37～178 min，中位时间72 min。术后4～6 d拔除导尿管。术后1～2 d复查腹部平片示双J管位置良好。围手术期无并发症发生。13例术后3个月膀胱镜检查见术区瘢痕组织形成，输尿管开口喷尿正常。结论应用亚甲蓝染色指导术者识别CG的困难输尿管开口，是一种微创、高效的方法。
Abstract:
ObjectiveTo investigate the value of resectoscope combined with methylene blue for finding difficult ureteral orifices in cystitis glandularis (CG).MethodsFrom June 2019 to September 2021, we performed standard resection of intravesical lesions in 13 patients with CG and difficult ureteral orifices, followed by thinsection resection of the target ureteral orifice area to initially identify the ureteral orifices. Intravesical instillation of 0.01% methylene blue solution was performed to observe ureteral orifice spraying in the methylene blue field. After 5 minutes, the bladder was rinsed with normal saline, the everted unstained mucosa was found in the ureteral wall, and the guide wire was inserted. The ureteroscope was replaced to confirm the ureteral lumen, and a doubleJ stent (DJS) was placed under guidance.ResultsThe DJS was successfully placed in all the 13 patients (23 sides) under the guidance of methylene blue staining. The operation time was 37-178 min, and the median time was 72 min. The catheter was removed in 4-6 d postoperatively. Reexaminations of abdominal image at 1-2 d after surgery showed that the DJS was in good position. No perioperative complications occurred. Thirteen patients had scar tissue formation in the surgical area under cystoscopy 3 months after surgery and normal urine spraying from the ureteral orifice.ConclusionThe application of methylene blue staining to guide the surgeon to identify difficult ureteral orifices in patients with CG is a minimally invasive and efficient method.

参考文献/References:

[1]中华医学会泌尿外科学分会，腺性膀胱炎诊治专家共识编写组.腺性膀胱炎临床诊断和治疗中国专家共识.中华泌尿外科杂志,2020,41(8):566-568.
[2]Riaz A, Casalino DD, Dalton DP. Cystitis cystica and cystitis glandularis causing ureteral obstruction. J Urol,2012,187(3):1059-1060.
[3]谷军飞,任立新,张勇,等.电切镜联合输尿管镜在腺性膀胱炎中寻找困难输尿管开口的应用.中国内镜杂志,2017,23(2):73-76.
[4]EspaillatRijo L, Siff L, Alas AN,et al. Intraoperative cystoscopic evaluation of ureteral patency: A randomized controlled trial. Obstet Gynecol,2016,128(6):1378-1383.
[5]王海峰,高旭,王燕,等.多种方法联合在寻找困难输尿管开口中的应用.中华泌尿外科杂志,2016,37(4):265-267.
[6]Bastianpillai C, Warner R, Beltran L, et al. Cystitis cystica and glandularis producing large bladder masses in a 16yearold boy. JRSM Open,2018,9(3):2054270417746060.
[7]Harik LR, O’Toole KM. Nonneoplastic lesions of the prostate and bladder. Arch Pathol Lab Med,2012,136(7):721-734.
[8]Bell TE, Wendel RG. Cystitis glandularis: benign or malignant? J Urol,1968,100(4):462-465.
[9]成海生,闫永吉,高文锋,等.特殊情况下的输尿管支架管置入术与文献复习.微创泌尿外科杂志,2018,7(1):26-29.
[10]Bohnenpoll T, Kispert A. Ureter growth and differentiation. Semin Cell Dev Biol,2014,36:21-30.
[11]Burdyga T, Lang RJ. Excitationcontraction coupling in ureteric smooth muscle: Mechanisms driving ureteric peristalsis. Adv Exp Med Biol,2019,1124:103-119.
[12]Luketic L, Murji A. Options to evaluate ureter patency at cystoscopy in a world without indigo carmine. J Minim Invasive Gynecol,2016,23(6):878-885.
[13]Gill WB, Huffman JL, Lyon ES,et al. Selective surface staining of bladder tumors by intravesical methylene blue with enhanced endoscopic identification. Cancer,1984,53(12):2724-2727.
[14]Lejoy A, Arpita R, Krishna B, et al. Methylene blue as a diagnostic aid in the early detection of potentially malignant and malignant lesions of oral mucosa. Ethiop J Health Sci,2016,26(3):201-208.
[15]陶伟,徐明,朱进,等.980 nm红激光经尿道膀胱肿瘤整块切除与经尿道膀胱肿瘤电切术治疗非肌层浸润性膀胱癌的疗效比较.中国微创外科杂志,2021,21(12):1086-1090.
[16]Chathuranga Ambegoda ALAM, Sagara Ruwan Kumara MG, Sandamalee K, et al. Cystoscopic extraction of an inadvertently placed ureteral stent in inferior vena cava. Asian J Urol,2020,7(4):373-375.
[17]Lu YT, Tingskov SJ, Djurhuus JC,et al. Can bladder fibrosis in congenital urinary tract obstruction be reversed? J Pediatr Urol, 2017,13(6):574-580.

备注/Memo

备注/Memo:
基金项目：国家自然科学基金项目（82060465）**通讯作者，Email：995374160@qq.com
更新日期/Last Update: 2022-11-25