urgent!The ureter is only 3 cm, and the doctor cleverly uses the bladder flavor to repair the "re -connection"

Recently, Liu Yongda, the chief team of Liu Yongda, the First Affiliated Hospital of Guangzhou Medical University, successfully completed the "resume" surgery for a patient with severe ureteral tubes, and cleverly "turned into" the lumen muscle flap into the ureter to reconstruct the urinary tract. Preservation of the kidneys and avoiding kidney fistulas. Nowadays, patients have recovered and discharged from discharge to return to normal urination.

When Ayong (pseudonym) undergo ureteral stones in a hospital in Guangdong, a 25 cm ureteral tube was torn off, just like the "sewer" collapsed and damaged. , Resulting in severe kidney infection, the final result may be removed.

Under the crisis, the local hospital urgently contacted the Department of Urology, the First Affiliated Hospital of Guangzhou Medical University, and entered the Haiyin Hospital area through emergencyly. Director Liu Yongda, who was on the way to receive a call from the emergency surgery, immediately folded back and rushed to the operating room non -stop.

Through urgent enhancement of CT examination, the patient's ureter is higher than the horizontal line of the kidneys. The entire ureter is only 3 cm disabled. "We have visited many patients with ureteral tubes, but there are very few defects such a long defect. See. "Director Liu Yongda decided after watching the inspection report that the laparoscopy was used to repair the bladder flap under the laparoscopy to repair ureteral transfusion surgery.

Ureutal torn is one of the most serious complications in ureteroscopic examination and treatment. The main reason is that there is a physiological stenosis in the ureter, or ureteral edema, stenosis, increased brittleness, thinning of the wall of the tube, etc. Essence When these conditions occur, the phenomenon of "holding the mirror" may occur during ureteroscopic surgery, that is, the ureter rot hugs the ureteroscopy tightly. At this time, if the ureteroscopy exits, the human ureter may exit with the ureteroscopy, which will cause the ureteroscopic to exit, causing it to cause The ureteral tube is torn.

In the past, the common repair methods were autologous kidney transplantation and intestinal ureteral surgery, but these two operations were not only trauma, but also many complications. Therefore, under limited medical resources, many hospitals and patients were forced to choose kidney resection surgery. Or do kidney fistula. However, renal resection surgery needs to sacrifice a kidney. For a long time, the renal fistula is not only inconvenient, the quality of life is affected, but also complications such as urinary tract infection and bladder stimulation.

In recent years, with the development of medical technology, the advantages of bladder petal ureteral surgery have been promoted and applied clinically due to their small trauma, mild pain, and fast postoperative recovery. However, this surgery is more difficult and has higher requirements on the technical level of operational doctors.

During the operation, the doctor first cut a rectangular muscle flap from the bladder wall according to the length of the torn ureter, and then stitched the cut muscle synthetic pipe as a new ureter and sutured the residual ureter. "It is recommended that the bladder petal ureteral surgery is usually used in patients with ureteral injuries with ureteral defects less than or equal to 6 cm of ureteralized ureteral damage. , Clinical needs "forced" doctors to continuously hone their techniques and make it impossible to become possible. Domestic doctors have already used the bladder petal ureteral surgery to take off the successful experience of tearing more than 7cm. The difficulty of surgical operations can be imagined.

"The robotic arm of the robot has the flexibility beyond the manpower. The advantages of the robot auxiliary laparoscopic surgery in providing the field of vision depth, suture, and cutting are obvious." Director Liu Yongda said Under the operation of experienced doctors, the success rate can be greatly improved.

Due to the high position of the patient's urinary tube damage, in order to avoid the increase in the incidence of complications during the occurrence of ureteral bladder coincidence in the surgery, Director Liu Yongda during the operation based on the specific situation of the patient and combined with rich experience to retain the complete completeness when separating the ureteral tube as much as possible. A small amount of fat tissue on the outer membrane and surface to prevent measures such as damage to the blood supply of the arteries and other measures to avoid complications such as postoperative urinary fistula and secondary stenosis.

The surgery was in one go. After the operation, Ayong reviewed the kidneys to see that there was no obvious effusion, and the recovery was also very good. Observing the recovery after a week.

The Department of Urology, the First Affiliated Hospital of Guangzhou Medical University, has been focusing on the treatment of diseases such as ureteral stenosis and ureteral injuries three years ago. Repeat surgery, dilatation surgery of the ball pocket, placed Mimo Case/Ellim stent, (robot auxiliary) long -stage bladder flap repair ureteral tubes, appendix fillets instead of ureter, tongue (cheek) mucosa supplement to replace ureteral surgery, solve a large number of large quantities Ureutal stenosis and ureter to tear. In June this year, the Guangzhou Urology Center was newly established to continue to work hard to protect the health of the people wholeheartedly.

(Guide expert: Liu Yongda, chief physician Liu Yongda, the First Affiliated Hospital of Guangzhou Medical University)

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