長期経過観察した回腸代用尿管の4例

Abstract

広範囲尿管欠損をきたした4例に対し, 回腸を利用して尿管再建を行った.いずれも逆流防止を行わない術式をとり良好な長期成績を得た.腎機能正常例では逆流防止術を省略できる可能性が示唆された

A total of four patients underwent ureteral replacement using ileum without the antireflux mechanism for extensive ureteral loss from 1985 to 1995. The indications included surgical trauma, retroperitoneal fibrosis, ureteral obstruction due to abscess, and ureteritis. One case had bilateral reconstruction. The followup interval ranged from 3 to 14 years. Urinary infections were noted in 2 cases. One patient, who had urinary infections and neurogenic bladder, had symptoms, but, in all cases, serum creatinine was unchanged or decreased and the pyelogram was normal or showed mild hydronephrosis. Thus, the procedure was considered successful in all cases. This procedure provides excellent long-term results for reconstruction of ureter when the normal ureter cannot be used. Creation of the antireflux mechanism may not be necessary in patients with normal renal function.