방광벽의 부분고정술을 이용한 요관방광 이식술의 3예
Three Cases of Partial Vesical Immobilization adjunct to Ureteroneocystostomy
이원석,
소속 상세정보
이원석 ( )
가톨릭대학교 의과대학
KMID : 0358319710120010123
Abstract
"Must urologist have been faced with a short ureter in need of reimplantation and have sutured the bladder wall to some pelvic point to accommodate for lack of ureteral length and to reduce tension at the site of ureterovesical anastomosis. Partial fixation of the bladder to the psoas fascia is necessary for development of long submucosal tunnel and it also prevent tightening of the implanted ureter. We reported here 3 patient whose ureters had been reimplanted by the method of Politano-Leadbetter following a technique with partial vesical immobilization. The first patient was 13 years old boy admitted to this hospital with mild hydronephrosis and hydroureter due to renal tuberculosis on right side. Because of stenosis of lower ureter in 1 cm. length, ureteral reimplantation was underwent by stretching the bladder and suturing it to psoas muscle. After operation, fever and right flank pain had subsided. A second patient of 57 years old woman had right flank colic, frequency and intermittent fever. Preoperative excretory urogram revealed mild hydronephrosis with ureteroectatic change due to suggestive ureteral stricture on left side secondary to renal tuberculosis. Distal ureter on left side was resected in approximately 4 cm. in length. Reimplantation was done with vesical immobilization and there was no evidence of vesicoureteral reflux it delayed cystogram 10 days after operation. The third patient had urinary leakage after ureterolithotomy on right side due to ureteral stricture and ureteral reimplantation was performed. Sixteen days later, follow up study showed no vesicoureteral reflux and all subjective symptoms were subsided."
키워드
ureteroneocystostomy;vesical immobilization;요관방광문합술
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