URETERAL TAPERING

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  • 尿管膀胱新吻合術における尿管縫縮
  • ニョウカン ボウコウ シン フンゴウジュツ ニ オケル ニョウカン ホウシ

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Abstract

Our experience with ureteral tapering at the time of ureteroneocystostomy in 9 megaureters is presented. 7 ureters were improved while 2 were failures with postoperative reflux. Ureters more than 1cm in diameter usually require tapering in children. Our surgical technique for ureteral tapering is as follows:<br>1. Lower one third to half of the ureter is dissected and kinks straightened and excess length excised.<br>2. A longitudinal strip of ureteral wall (5-8cm long) is excised and its size is reduced to 4-8mm in diameter.<br>3. Ureteral edge is reapproximated with a running 4-0 chromic catgut stitch.<br>4. The ureter is reimplanted into the bladder through a long (3-5cm) submucosal tunnel.<br>5. A 5 Fr. or 8 Fr. splint catheter is placed in the ureter for 10 to 14 days postoperatively.<br>6. Tapering is usually limited to the lower ureter and upper ureteral repair is rarely indicated.

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