CAJ | 학술논문

目的探讨不同类型输尿管先天性畸形的最优治疗手段.方法回顾性分析119例输尿管先天性畸形的治疗,其中开放手术85例(其中11例为双侧病变,其他为单侧病变,共计96例次),输尿管成形术58例,端端吻合术3例,输尿管膀胱再植术25例,输尿管囊肿扩张切除1例,巨输尿管裁剪术9例；内镜下手术15例,其中输尿管扩张6例,输尿管囊性扩张裁剪4例、电切5例.结果 119例患者中111例(93.3％)获得随访,随访时间3个月～11年,其中开放手术97例次,成功92例,失败5例.输尿管成形、输尿管膀胱再植术一次性成功率分别为94.3％ (55/58)和93.3％( 24/25)；输尿管端端吻合、囊性扩张裁剪及电切后均获满意效果；巨输尿管裁剪术后有94.1％ (8/9)效果满意.结论开放手术目前仍是输尿管先天性畸形的主要治疗手段.腔内镜下治疗具有简单、痛苦小等优点,更适用于输尿管出口囊肿治疗,而对于输尿管狭窄治疗的远期效果不理想.
목적 탐토불동류형수뇨관선천성기형적최우치료수단.방법 회고성분석119례수뇨관선천성기형적치료,기중개방수술85례(기중11례위쌍측병변,기타위단측병변,공계96례차),수뇨관성형술58례,단단문합술3례,수뇨관방광재식술25례,수뇨관낭종확장절제1례,거수뇨관재전술9례；내경하수술15례,기중수뇨관확장6례,수뇨관낭성확장재전4례、전절5례.결과 119례환자중111례(93.3％)획득수방,수방시간3개월～11년,기중개방수술97례차,성공92례,실패5례.수뇨관성형、수뇨관방광재식술일차성성공솔분별위94.3％ (55/58)화93.3％( 24/25)；수뇨관단단문합、낭성확장재전급전절후균획만의효과；거수뇨관재전술후유94.1％ (8/9)효과만의.결론 개방수술목전잉시수뇨관선천성기형적주요치료수단.강내경하치료구유간단、통고소등우점,경괄용우수뇨관출구낭종치료,이대우수뇨관협착치료적원기효과불이상.
Objective To investigate the best strategy for management of congenital ureter malformations.Methods One hundred and nineteen cases of congenital ureter malformations were analyzed,in which 85 cases were treated with open surgery (Bilateral lesions in 12 cases,the others were unilateral lesions).58 cases had angioplasty ureter,3 cases had end-to-end anasto-mosis,25 cases had ureterovesical replantation,1 case had ureterocele excision,9 cases of giant ureters had surgery cutting and 15 cases were managed by endoscopic surgery,including 6 cases of ureteral expansion,4 cases of ureterocele cutting,5 cases of electricity cutting ureterocele.Results One-time success rate of the treatment of ureter forming and bladder-ureter replantation was respectively 94.3％ and 93.3％ ; treatment with end-to-end ureter anastomosis and the cut and electricity cutting of the cyst was good; 9 cases were satisfied after Giant ureteral clipping(94.1％ ).Conclusions The open surgery is still the primary method to treat the congenital ureter malformations.Endoscopic treatment with the advantage of a minimal invasive seems optimistic for the treatment of ureter outlet's cyst,but the long-term effects of endoscopic treatment for ureteral stricture are not satisfied.