Adult iatrogenic ureteral injury and stricture-incidence and treatment strategies.
Adult iatrogenic ureteral injury and stricture-incidence and treatment strategies.
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DOI：
10.1016/j.ajur.2018.02.003
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发表时间：
2018-04
影响因子：
2.6
通讯作者：
Fisch M
中科院分区：
文献类型：
--
作者：
Gild P;Kluth LA;Vetterlein MW;Engel O;Chun FKH;Fisch M
医源性输尿管损伤和狭窄是盆腔手术和放射治疗的常见并发症。如果不及时治疗，它们与严重的短期和长期并发症有关，如尿瘤、脓毒症、肾衰竭和肾单位损失。治疗取决于诊断的时机，以及损伤的程度，范围从简单的内镜治疗到使用带蒂移植物的复杂手术重建。虽然输尿管组织工程的最新进展是有前途的主题仍然是报道不足。从历史上看，腹腔镜和机器人辅助方法是开放手术的一个领域，已在小病例系列中证明了其可行性，并越来越多地用作重建手术的手段。本文就输尿管损伤和狭窄的发生率及治疗的最新进展作一综述。
Iatrogenic ureteral injuries and strictures are relatively common complication of pelvic surgery and radiation treatment. Left untreated they are associated with severe short- and long-term complications such as urinoma, septic state, renal failure, and loss of a renal unit. Treatment depends on timing of diagnosis, as well as extent of injury, and ranges from simple endoscopic management to complex surgical reconstruction under usage of pedicled grafts. While recent advances in ureteral tissue engineering are promising the topic is still underreported. Historically a domain of open surgery, laparoscopic and robotic-assisted approaches have proven their feasibility in small case series, and are increasingly being utilized as means of reconstructive surgery. This review aims to give an outline of incidence and treatment of ureteral injuries and strictures in light of the latest advances.