肾细胞癌部分切除后的尿瘘

B. Guliev
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引用次数: 1

摘要

肾部分切除术后泌尿道瘘管是少见的并发症。其发展、预防和治疗的原因是多方面的。本文就不同入路肾部分切除术后尿漏的发生率、尿瘘发生的预测因素、术中可能的预防和治疗方法进行分析。所获得的数据表明,肿瘤的大小,其内生性质和接近肾盆腔系统,以及其缺陷的缝合,可以预测尿瘘(UFs)的发展。一些作者指出长时间缺血和大量失血量对UFs的发生有影响。治疗UFs的主要方法是输尿管支架置入或经皮肾盆腔系统引流。对于长期持续性UFs,选择的方法可以是同时置入2个支架,逆行或经皮注射纤维蛋白胶,经皮冷冻消融UFs。
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Urinary fistulas after partial nephrectomy in renal cell carcinoma
Urinary fistulas after partial nephrectomy are rare complications of this operation. There are various reasons for their development, prevention and treatment. This review analyzes the results of the cases' prevalence of urine leakage after partial nephrectomy with various approaches, occurrence's predictors of urinary fistulas, possible ways of their intraoperative prevention and treatment methods. The obtained data show that the size of tumors, their endophytic nature and proximity to the kidney pelvicalyceal system, as well as suturing of its defect, can be predictors of the development of urinary fistulas (UFs). Some authors point to the influence of long ischemia time and high blood loss on the occurrence of UFs. The main method of treating UFs is ureteral stenting or percutaneous drainage of the kidney pelvicalyceal system. For long-term persistent UFs, the method of choice can be simultaneous introduction of 2 stents, retrograde or percutaneous injection of fibrin glue, percutaneous cryoablation of the UFs.
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