Preoperative simulation by volume rendering image and intraoperative navigation by ultrasound for posterior urethroplasty: A report of initial three cases
Preoperative simulation by volume rendering image and intraoperative navigation by ultrasound for posterior urethroplasty: A report of initial three cases
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后尿道成形术术前体绘制模拟及术中超声导航：附三例报告
DOI：
10.1002/iju5.12040
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Akihiro Kanematsu Kenji Nakamura Noriko Kotoura Takahiko Hashimoto Shingo Yamamoto
中科院分区：
文献类型：
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作者：
野田俊輔;塚原孝典;松岡大輔;日高義彦;粟津緑;Akihiro Kanematsu Kenji Nakamura Noriko Kotoura Takahiko Hashimoto Shingo Yamamoto
在后尿道成形术中，近端尿道残端的暴露是决定手术效果的最重要步骤。然而，这有时是困难的，由于前列腺或覆盖疤痕组织的偏差。我们提出了一种新的术前模拟和术中导航方法，这一步。病例介绍三例患者进行切除和一期吻合后尿道断裂骨盆骨折。术前，根据钆增强磁共振图像构建后尿道的容积渲染图像，以便在所有3例病例中从术者的角度进行模拟。术中导航进行了两名患者通过使用经直肠超声，可视化的声学阴影膀胱镜插入前列腺尿道通过膀胱造口术道。将覆盖的瘢痕组织朝向导航识别的尿道残端移除。尿道成形术是成功的，在所有三个patients.ConclusionThe目前的方法是有用的近端尿道残端的精确识别。
IntroductionIn posterior urethroplasty, exposure of the proximal urethral stump is the most important step that determines surgical outcome. However, this is sometimes difficult due to deviation of the prostate or overlying scar tissue. We present a novel preoperative simulation and intraoperative navigation method for this step.Case presentationThree patients underwent excision and primary anastomosis for posterior urethral disruption after pelvic fracture. Preoperatively, volume‐rendering image of the posterior urethra was constructed from gadolinium‐enhanced magnetic resonance image, enabling simulation from the viewpoint of the operator in all three cases. Intraoperative navigation was performed in two patients by using transrectal ultrasound, visualizing the acoustic shadow of a cystoscope inserted into the prostatic urethra via the cystostomy tract. The overlying scar tissue was removed toward the urethral stumps identified by navigation. Urethroplasty was successful in all three patients.ConclusionThe present methods were useful for precise identification of the proximal urethral stump.