原発性膀胱尿管逆流に対する手術術式と手術成績

概要

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From 1974 to 1983, a total of 116 children (202 ureters) with primary vesicoureterl reflux (VUR) were treated by the ureteroneocystostomy. There were 60 males and 56 females. Their ages ranged from 4 months to 15 years, with a mean age of 6.2 years. Our principal surgical techniques were modified Paquin and modified Politano-Leadbetter (P-L) methods. In either method, the submucosal tunnel was created as long as 3 to 4 cm and the new ureteral orifice was located about 1cm distal to the original one. Postoperative complications were as follows: modified Paquin method (140 ureters) - distal ureteral stricture (4 ureters), paraureteral diverticulum (2 ureters) and persistent reflux (1 ureter), modified P-L method (44 ureters) - paraureteral diverticulum (1 ureter) and persistent reflux (1 ureter). Therefore, the success rate of the both methods was 95%. It is concluded that most of VUR can be successfully corrected by intravesical ureteroneocystostomy such as modified P-L method. However, there are a few VUR with massively dilated ureter for which combined intra-and extravsical procedure such as modified Paquin method is necessary, and surgeons must also be familiar with this method.
日本小児外科学会の論文
1986-08-20