Volume 20 Issue 5
May  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(5): 770-772
WEI Hai-bin, BAI Yu-chen, MAO Zu-jie, ZHANG Qi, LI En-hui, QI Xiao-long, LIU Feng, ZHANG Da-hong. Observation on the effect of complete laparoscopic bladder flap plasty for full-length ureteral avulsion[J]. Chinese Journal of General Practice, 2022, 20(5): 770-772. doi: 10.16766/j.cnki.issn.1674-4152.002450
Citation: WEI Hai-bin, BAI Yu-chen, MAO Zu-jie, ZHANG Qi, LI En-hui, QI Xiao-long, LIU Feng, ZHANG Da-hong. Observation on the effect of complete laparoscopic bladder flap plasty for full-length ureteral avulsion[J]. Chinese Journal of General Practice, 2022, 20(5): 770-772. doi: 10.16766/j.cnki.issn.1674-4152.002450
shu

Observation on the effect of complete laparoscopic bladder flap plasty for full-length ureteral avulsion

doi: 10.16766/j.cnki.issn.1674-4152.002450
  • 1.

    Department of Urology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, Zhejiang 310014, China

Funds:

 WKJ2012-2-019

  • Received Date: 2021-05-21
    Available Online: 2022-09-05
    Abstract
  •   Objective  To explore the feasibility and safety of laparoscopic bladder flap reconstruction and pedicled omentum coverage for full-length ureteral avulsion (from the junction of the renal pelvis and ureter to the end of the ureter).  Methods  The clinical data of 5 patients with full-length ureteral avulsion admitted to the Department of Urology, Zhejiang Provincial People's Hospital from November 2014 to August 2019, including 3 cases on the right side and 2 cases on the left side, were retrospectively analysed. All cases of ureteral avulsion occurred during the endoscopic lithotripsy in the other hospital. Three patients underwent one-stage emergency surgical repair. One patient had repeated replacement of the DJ tube and second-stage surgical repair 1 year later. Another patient underwent open surgery during the initial surgery to repair the ureter in situ. Second-stage surgical repair was performed 5 days later due to urine leakage and peritonitis. All patients underwent complete laparoscopic bladder flap formation and pedicled omentum wrapping surgery. Clinical data were collected and recorded during the perioperative and follow-up period.  Results  All repair and reconstruction operations were successfully completed. No urine extravasation, retroperitoneal infection and hydronephrosis occurred during hospitalisation. For the 3 patients undergoing emergency surgery, the DJ tube was replaced once and removed 6 months postoperatively. In the patient who underwent second-stage operation 5 days later, the DJ tube was changed 3 months postoperatively, and the patient was still in the state of intubation. In another patient, the DJ tube was changed repeatedly due to backache, and the patient underwent laparoscopic nephrectomy on the affected side 1 year after the operation. Except for the patient undergoing nephrectomy, no aggravated separation of the collection system and stenosis of the anastomosis occurred. Postoperative urination was smooth, and frequence and ureteral reflux were not obvious. The cystography was pear-shaped and biased to the affected side, and the volume was slightly smaller.  Conclusion  Complete laparoscopic bladder flap plasty and pedicled omental wrap repair surgery is a safe and effective minimally invasive treatment method for full-length ureteral defects.

     

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