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目的探讨内镜会师治疗输尿管断裂的的方法和疗效。方法自2005年6月～2010年2月共收治输尿管瘘患者6例。4例发生于子宫切除手术后,2例发生于直肠癌术后。尿瘘发生时间为术后2～24d,平均13d。术后行IVP、逆行肾盂造影等检查确诊输尿管完全横断,断端分离。术中行B超引导穿刺肾造瘘,顺行放置斑马导丝,输尿管镜于输尿管远侧断端出去向近侧断端寻找到斑马导丝后拉出,顺行放置双J管,留置肾造瘘管。结果留置双J管2～3个月,经肾造瘘造影复查无输尿管狭窄,可拔除双J管及肾造瘘管,随访1～2年。1例术后出现狭窄行输尿管镜下内切开后治愈。结论对于手术等造成输尿管断裂,内镜下会师,放置肾造瘘、双J管治疗具有微创、高效等优点。
Objective To explore the method and effect of endoscopic treatment of ureteral rupture. Methods From June 2005 to February 2010, a total of 6 patients with ureteral fistula were treated. 4 cases occurred after hysterectomy, 2 cases occurred in the postoperative rectal cancer. Urinary fistula occurred after 2 ~ 24d, an average of 13d. Postoperative IVP, retrograde pyelography confirmed ureter completely transected, stump separation. B-guided intraoperative ultrasound guided puncture nephrostomy, placed zebra guidewire along the line, ureteroscopy distal to the ureter to the proximal end to find the zebra guide wire to pull out, placed in parallel double J tube, indwelling kidney Fistula. Results indwelling double J tube 2 to 3 months, review of nephrostomy angiography no ureteral stricture, double J tube and renal fistula can be removed, followed up for 1 to 2 years. A case of stenosis occurred after ureteral incision was cured. Conclusions Surgery caused by ureteral rupture, endoscopic meeting, placement of renal ostomy, double J tube treatment with minimally invasive, efficient and so on.