儿童肾盂成形术后再梗阻的处理思考

周辉霞; 曹华林

doi:10.13201/j.issn.1001-1420.2023.03.001

儿童肾盂成形术后再梗阻的处理思考

周辉霞^1, ,,
曹华林²

- 1.
  解放军总医院第七医学中心儿科医学部儿童泌尿外科(北京，100700)
- 2.
  广西壮族自治区南溪山医院泌尿外科
基金项目:
广西壮族自治区卫生健康委员会自筹课题(No：Z20211603)；首都医学发展科研专项(No：2022-2-5083)；军队计生专项(No：18JS001)

详细信息

作者简介:
周辉霞, 医学博士，主任医师，教授，博士生导师。中国人民解放军总医院儿科医学部副主任，儿童泌尿外科主任。中华医学会泌尿外科学分会小儿泌外学组组长；中国医师协会儿童重症医师分会结构畸形外科专业委员会主任委员；北京医学会泌尿外科学分会机器人学组副组长；中国医师协会医学机器人分会常务委员。Journal of Urology审稿人，《中华泌尿外科杂志》编委，《中华小儿外科杂志》通讯编委。
长期致力于小儿外科微创手术技术研究，特别是对小儿泌尿系疾病的诊断和治疗有较深入的研究。设计、改良并创新了多种小儿泌尿外科手术方式，解决了困扰小儿泌尿外科治疗领域的众多世界性难题，尤其擅长小儿泌尿系统高难度重建性手术的微创治疗，建立了一整套利用腹腔镜及机器人技术对小儿泌尿系统先天畸形类疾病进行矫治的体系。手术效果好，恢复快，创伤小，成功率高。吸引了数十位来自美国、中国香港、中国台湾、巴基斯坦、巴拿马、毛里求斯等地的医师专程来院进修学习，并多次受邀前往美国、德国及“一带一路”沿线的印度、巴基斯坦、马来西亚和塞尔维亚等国和新疆喀什地区进行肾盂输尿管连接部畸形、膀胱外翻、尿道下裂等手术的教学演示与术式推广。同时，团队被国际膀胱外翻协作组授予国际膀胱外翻-尿道上裂-尿失禁中国治疗中心称号。自2012年起通过举办培训班、手术带教等方式在国内大力推广小儿泌尿外科微创技术，为我国各大区域医学中心输送了大批小儿泌尿外科微创治疗技术的骨干力量，迅速提高了我国小儿泌尿外科整体的微创技术水平。
获宋庆龄儿科医学奖1项，北京市科学技术二等奖1项，北京市科学技术三等奖1项，中国出生缺陷干预救助基金会科技成果奖1项，军队医疗成果二等奖1项。两次获得军队优秀专业技术人才岗位津贴。承担国家及省部级课题10余项，以第一/通讯作者发表核心期刊论著80余篇，SCI论著16篇，获软件著作权4项，发明专利3项

通讯作者: 周辉霞，E-mail：huixia99999@163.com

中图分类号: R692.2

收稿日期: 2022-12-02

刊出日期: 2023-03-06

The management of failed pyeloplasty in children

ZHOU Huixia^1, ,,
CAO Hualin²

- 1.
  Department of Urology, Senior Department of Pediatrics, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China
- 2.
  Department of Urology, Nanxi Shan Hospital of Guangxi Zhuang Autonomous Region

More Information

Corresponding author: ZHOU Huixia, E-mail: huixia99999@163.com

Received Date: 02 December 2022

Publish Date: 06 March 2023

摘要

摘要: 肾盂成形术后再梗阻一直是泌尿外科手术治疗的难点，随着科学技术的不断发展，泌尿外科医师对再次手术的理解也在不断变化，本文将结合文献与笔者操作经验对肾盂成形术后再梗阻的治疗进行更为深入地探讨，以期为广大同行提供借鉴。
- 再梗阻 /
- 肾盂输尿管成形术 /
- 肾积水 /
- 儿童
Abstract: The management for recurrent ureteropelvic junction obstruction can be technically challenging. With the development of science and technology, urologists' understanding for reoperation is also changing. This paper will combine the latest literature and the author's operating experience to conduct a more in-depth discussion on the management of recurrent ureteropelvic junction obstruction, in order to provide reference for the majority of peers.
- recurrence obstruction /
- pyeloplasty /
- hydronephrosis /
- child

HTML全文

参考文献(29)

[1]	Notley RG, Beaugie JM. The long-term follow-up of Anderson-Hynes pyeloplasty for hydronephrosis[J]. Br J Urol, 1973, 45(5): 464-457. doi: 10.1111/j.1464-410X.1973.tb06804.x
[2]	Klingler HC, Remzi M, Janetschek G, et al. Comparison of open versus laparoscopic pyeloplasty techniques in treatment of uretero-pelvic junction obstruction[J]. Eur Urol, 2003, 44(3): 340-345. doi: 10.1016/S0302-2838(03)00297-5
[3]	Dy GW, Hsi RS, Holt SK, et al. National Trends in Secondary Procedures Following Pediatric Pyeloplasty[J]. J Urol, 2016, 195(4 Pt 2): 1209-1214.
[4]	Cao H, Zhou H, Liu K, et al. A modified technique of paraumbilical three-port laparoscopic dismembered pyeloplasty for infants and children[J]. Pediatr Surg Int, 2016, 32(11): 1037-1045. doi: 10.1007/s00383-016-3958-2
[5]	曹华林, 周辉霞, 王蕊, 等. 儿童肾盂成形术后再梗阻原因及再次行腹腔镜手术的可行性[J]. 中华泌尿外科杂志, 2017, 38(5): 362-366. doi: 10.3760/cma.j.issn.1000-6702.2017.05.011
[6]	Jabbour ME, Goldfischer ER, Klima WJ, et al. Endopyelotomy after failed pyeloplasty: the long-term results[J]. J Urol, 1998, 160(3 Pt 1): 690-2;discussion 692-693.
[7]	Braga LH, Lorenzo AJ, Skeldon S, et al. Failed pyeloplasty in children: comparative analysis of retrograde endopyelotomy versus redo pyeloplasty[J]. J Urol, 2007, 178(6): 2571-2575;discussion 2575. doi: 10.1016/j.juro.2007.08.050
[8]	Veenboer PW, Chrzan R, Dik P, et al. Secondary endoscopic pyelotomy in children with failed pyeloplasty[J]. Urology, 2011, 77(6): 1450-1454. doi: 10.1016/j.urology.2010.10.021
[9]	Corbett HJ, Mullassery D. Outcomes of endopyelotomy for pelviureteric junction obstruction in the paediatric population: A systematic review[J]. J Pediatr Urol, 2015, 11(6): 328-336. doi: 10.1016/j.jpurol.2015.08.014
[10]	Wein AJ, Kavoussi LR, Partin AW. Campbell-Walsh Urology 11th edition[M]. Philadelphia: Elsevier Health Sciences, 2015: 1108-1125.
[11]	Meretyk I, Meretyk S, Clayman RV. Endopyelotomy: comparison of ureteroscopic retrograde and antegrade percutaneous techniques[J]. J Urol, 1992, 148(3): 775-782;discussion 782-783.
[12]	Lee M, Lee Z, Strauss D, et al. Multi-institutional Experience Comparing Outcomes of Adult Patients Undergoing Secondary Versus Primary Robotic Pyeloplasty[J]. Urology, 2020, 145: 275-280. doi: 10.1016/j.urology.2020.07.008
[13]	Jacobson DL, Shannon R, Johnson EK, et al. Robot-Assisted Laparoscopic Reoperative Repair for Failed Pyeloplasty in Children: An Updated Series[J]. J Urol, 2019, 201(5): 1005-1011. doi: 10.1016/j.juro.2018.10.021
[14]	Chandrasekharam V, Babu R. A systematic review and metaanalysis of open, conventional laparoscopic and robot-assisted laparoscopic techniques for re-do pyeloplasty for recurrent uretero pelvic junction obstruction in children[J]. J Pediatr Urol, 2022, 18(5): 642-649. doi: 10.1016/j.jpurol.2022.08.025
[15]	马立飞, 周辉霞, 周晓光, 等. 儿童腹腔镜再次肾盂成形术与初次肾盂成形术的疗效比较[J]. 临床泌尿外科杂志, 2020, 35(9): 729-733. doi: 10.13201/j.issn.1001-1420.2020.09.012
[16]	Gill IS, Cherullo EE, Steinberg A, et al. Laparoscopic ureterocalicostomy: initial experience[J]. J Urol, 2004, 171(3): 1227-1230. doi: 10.1097/01.ju.0000114233.66534.b0
[17]	Gite VA, Siddiqui AK, Bote SM, et al. Ureterocalycostomy-final resort in the management of secondary pelvi-ureteric junction obstruction: our experience[J]. Int Braz J Urol, 2016, 42(3): 501-506. doi: 10.1590/S1677-5538.IBJU.2015.0368
[18]	Arap MA, Andrade H, Torricelli FC, et al. Laparoscopic ureterocalicostomy for complicated upper urinary tract obstruction: mid-term follow-up[J]. Int Urol Nephrol, 2014, 46(5): 865-869. doi: 10.1007/s11255-013-0591-z
[19]	Mittal S, Aghababian A, Eftekharzadeh S, et al. Robot-Assisted Laparoscopic Ureterocalicostomy in the Setting of Ureteropelvic Junction Obstruction: A Multi-Institutional Cohort[J]. J Urol, 2022, 208(1): 180-185. doi: 10.1097/JU.0000000000002484
[20]	Lee Z, Lee M, Koster H, et al. A Multi-Institutional Experience With Robotic Ureteroplasty With Buccal Mucosa Graft: An Updated Analysis of Intermediate-Term Outcomes[J]. Urology, 2021, 147: 306-310. doi: 10.1016/j.urology.2020.08.003
[21]	Kroepfl D, Loewen H, Klevecka V, et al. Treatment of long ureteric strictures with buccal mucosal grafts[J]. BJU Int, 2010, 105(10): 1452-1455.
[22]	Zhao LC, Weinberg AC, Lee Z, et al. Robotic Ureteral Reconstruction Using Buccal Mucosa Grafts: A Multi-institutional Experience[J]Eur Urol, 2018, 73(3): 419-426. doi: 10.1016/j.eururo.2017.11.015
[23]	曹华林, 周辉霞, 马立飞, 等. 机器人辅助腹腔镜口腔黏膜修复小儿长段输尿管狭窄的初步临床应用[J]. 临床泌尿外科杂志, 2018, 33(6): 435-438. doi: 10.13201/j.issn.1001-1420.2018.06.004
[24]	Liang C, Wang J, Hai B, et al. Lingual Mucosal Graft Ureteroplasty for Long Proximal Ureteral Stricture: 6 Years of Experience with 41 Cases[J]. Eur Urol, 2022, 82(2): 193-200. doi: 10.1016/j.eururo.2022.05.006
[25]	Yang K, Fan S, Wang J, et al. Robotic-assisted Lingual Mucosal Graft Ureteroplasty for the Repair of Complex Ureteral Strictures: Technique Description and the Medium-term Outcome[J]. Eur Urol, 2022, 81(5): 533-540. doi: 10.1016/j.eururo.2022.01.007
[26]	Cao H, Zhou H, Yang F, et al. Laparoscopic appendiceal interposition pyeloplasty for long ureteric strictures in children[J]. J Pediatr Urol, 2018, 14(6): 551. e1-551. e5. doi: 10.1016/j.jpurol.2018.06.017
[27]	Yarlagadda VK, Nix JW, Benson DG, et al. Feasibility of Intracorporeal Robotic-Assisted Laparoscopic Appendiceal Interposition for Ureteral Stricture Disease: A Case Report[J]. Urology, 2017, 109: 201-205. doi: 10.1016/j.urology.2017.08.017
[28]	Jun MS, Stair S, Xu A, et al. A Multi-Institutional Experience With Robotic Appendiceal Ureteroplasty[J]. Urology, 2020, 145: 287-291. doi: 10.1016/j.urology.2020.06.062
[29]	Liu D, Zhou H, Hao X, et al. Laparoscopic Yang-Monti Ureteral Reconstruction in Children[J]. Urology, 2018, 118: 177-182. doi: 10.1016/j.urology.2018.04.034