2011.11.29 京都 8th Annual Meeting of the East Asian Society of Endourology. ポスター
Ooishi Y, Azumi M, Minami K, Harabayashi T, Nagamori S.
A case of laparoscopic ileal ureteral substitution.
We report a case of 36-year-old woman who underwent laparoscopic ileal ureteral substitution for hydronephrosis due to gynecological malignancy. In 2001, she presented with bilateral hydronephrosis due to malignant lymphoma of the uterus. Left renal dysfunction was already irreversible and a stent was placed in the right ureter. Lymphoma was well controlled by 39 Gy of external beam radiation, however, ureter stenting is required for following 8 years. After several episodes of urinary tract infection, she developed pelvic abscess around the right ureter, which required transvaginal drainage and percutaneous nephrostomy. Laparoscopic ileal ureteral substitutution was performed in 2010. After the ureter and bladder were mobilized with 3-port method, 20 cm of the ileum was isolated through the umbilical incision and anastomosed to the upper ureter and bladder laparoscopically. Operating time was 205 minutes. The patient has preserved good renal function and has been free from urinary tract infection. Reports of laparoscopic ileal ureteral substitution associated with gynecological malignancy are rare, but it will benefit patients in terms of QOL.