查詢結果分析
來源資料
頁籤選單縮合
題 名 | Retrocaval Ureter--Case Analysis and Literature Review=下腔靜脈後輸尿管之病例分析及文獻回顧 |
---|---|
作 者 | 查岱龍; 孫光煥; 王曉暹; 馬正平; 張聖原; 于大雄; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 30:4 民86.07-08 |
頁 次 | 頁262-267 |
分類號 | 416.274 |
關鍵詞 | 下腔靜脈後輸尿管; Retrocaval ureter; Computerized tomography; Ureteral Catheterization; |
語 文 | 英文(English) |
中文摘要 | Retrocaval ureter, also called anteureteral vena cava, is a rare disease caused by a maldevelopment of the inferior vena cava.This abnormality leads to varing degrees of ureteral compression which can result in gradual development of hydronephrosis and dilataton of the proximal ureter.Early diagno- sis and treatment are imprtant to salvage remaining renal function before extreme renal deterioration occur. Two types of retrocaval ureter were distinguished on the basis of radiographic criteria.Type 1(low loop),the more common form,has an S or fish hook deformity at the point of obstruction.Type 2 (high loop) is noted to be sickle-shaped or inverted Jshaped at the level of the obstruction. From 1978 to 1995,14 patients (mean age 42 years, range 14-52; male/female ratio 3.6:1) were diagnosed with retrocaval ureter preoperatively at our institution.The diagnostic procedures included intravenous pyelography, retrograde phelography, inferior venocavography and Ct scan with ureteral cathe- terization. The type 1 retrocaval ureter involved 11 cases and type 2,3 cases. The 14 cases ncluded 2 nonoperative patients.Eight cases were diagnosed by CT scan with ureteral catheterization, and 6 by inferior venocavography.Operative procedures were performed in 12 patients, including Anderson-Hynes operation in 4 (including two cases with stone formation),transection of ureter at the retrocaval level and uretero-ureteric anastomosis in 5 and segmetal resection of stenotic ureter behind the vana cava and end-to-end anastomosis in 3.The twonon- operative patients were type 2, and were periodically followed up with renal function tests and diuretic renal scans. During follow up,no complications were noted.The mean follow up was 2 years.The advancement of imaging studies afford more convenience for urologists and patients,as many diseases can now be easily diagnosed pre-operatively rather than post-operatively as in the past.Early detection and rapid appropriate treatment can be applied only when physicians highly suspect the possibility of disease.Early detection and treatment are essential to remedy a disease such as retrocaval ureter. |
英文摘要 | 下腔靜脈後輸尿管亦稱為輸尿管前下腔靜脈,是下腔靜脈不正常發育所造成的一 種腔見疾病。此種異常的現象常易造成輸尿管不同種程度的壓迫而導致輸尿管擴大及水腎的 情形,早期診斷及治療對於腎臟功能的維護是相當重要的。本院自一九七八至一九九五年一 共十四位病人(平均年齡四十二歲,男女比為三點六比一)在手術前診斷為下腔靜脈後腎孟 攝影,下腔靜脈攝影及輸尿管導管置放合併電腦斷層檢查。其中第一型有十一例,第二型有 三例,其中六位病人利用下腔靜脈攝影,八位利用輸尿管導管置放合併電腦斷層檢查在術前 確立診斷。十二位病人接受手術治療,其中將部份輸尿管切除並作腎盂輸尿管縫合者一共十 位(包括兩位有結石者),兩位接受腎盂整形術,另外兩位第二型患者則行保守療法,定期 接受臀功能及核子醫學檢查。平均追蹤時間為兩年,並無任何併發症發生。由於影像學的進 步提供了醫師及病人更多的幫助,許多疾病利用這些檢查,較之以往,更能達到術前確立診 斷的目的,然而,任何疾病一如下腔靜脈後輸尿管,唯有在醫師的高度警覺下,才能達到早 期診斷及治療的目的。 |
本系統中英文摘要資訊取自各篇刊載內容。