后腹腔镜肾盂成形术治疗肾盂输尿管连接处梗阻

文秀华; 张辉; 冯志刚; 卢学仁; 张永; 刘太阳; 霍自豪

后腹腔镜肾盂成形术治疗肾盂输尿管连接处梗阻

- 驻马店市中心医院泌尿外科(河南驻马店, 463000)

详细信息

通讯作者: 文秀华,E-mail:xiuhuawen@sina.com

中图分类号: R572

收稿日期: 2011-09-15

Retroperitoneal laparoscopic dismembered pyeloplasty for the treatment of ureteropelvic junction obstruction

- Department of Urology, Central Hospital of Zhumadian, Zhumadian, Henan, 463000, China

More Information

Corresponding author: WEN Xiuhua, E-mail: xiuhuawen@sina.com

Received Date: 15 September 2011

摘要

摘要: 目的:评价后腹腔镜肾盂成形术治疗肾盂输尿管连接处梗阻(ureteropelvic junction obstruction,UPJO)技术要点及临床疗效。方法:通过后腹腔途径在腹腔镜下对30例UPJO患者行离断式肾盂成形术,其中男18例,女12例,年龄在16~48岁;异常血管压迫4例,合并泌尿系感染8例。结果:30例手术均获成功,无一例中转开放手术。手术时间120~235 min,平均105 min;出血量85~135 ml,平均115 ml。30例术后随访6~24个月,经B超、IVU检查,肾盂输尿管吻合口未见明显狭窄,患肾积水明显减轻或消失,临床症状消失。结论:后腹腔镜肾盂成形术是一种创伤小、安全可靠、疗效确切的微创手术方法。
- 后腹腔镜,肾盂成形术,肾盂输尿管连接处梗阻
Abstract: Objective:To investigate the clinical effects of retroperitoneal laparoscopic pyeloplasty for ureteropelvic junction (UPJ)obstruction,and review the technical deypoints.Method:The clinical data of 30 patients with UPJ obstruction who underwent retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty were retrospectively analyzed.There were 18 males and 12 females,their age ranged from 16 to 48 years.Four cases were compression from crossing vessels and 8 cases were complicated with urinary tract infection.Result:Retroperitoneal pyeloplasty was performed successfully in all 30 cases.The operative time ranged from 120 to 235 min (mean 105 min).The estimated blood lost ranged from 85 to 135 ml (mean 115 ml).During the follow up of 6 to 12 months,B-ultrasound and IVU showed the hydronephrosis relieved obviously in all patients.and no anastomotic stoma stricture of UPJ developed.At the same time,the clinical symptoms disappeared among these cases.Conclusion:Retroperitoneal laparoscopic dismembered pyeloplasty is a minimally invasive surgical method,which has the advantages of high efficiency,reliability,safety,mini- invasion and rapid recovery.
- ureteropelvic junction obstruction

HTML全文

参考文献(10)

[1]	SRIVASTAVA A,SINGH P,MAHESHWARI R,et al.Laparoscopic pyeloplasty:a versatile alternative to open pyeloplasty[J].Urol Int,2009,83:420-424.
[2]	ZHANX,LI H Z,WANS G,et al.Retroperitoneal laparoscopic dismembered pyeloplasty:experience with 50 cases[J].Urology,2005,66:514-517.
[3]	李宏召,张旭,黄定平,等.后腹腔镜与开放离断肾盂成形术的临床效果比较[J].临床泌尿外科杂志,2005.20(9):517-520.
[4]	GALLO F,SCHENONE M,GIBERTI C.Ureteropelvic junction obstruction:which is the best treatment today[J]?J Laparoendosc Adv SurTech A,2009,19:657-662.
[5]	CALVERT R C,MORSY M M,ZELHOF B,et al.Comparison of laparoscopic and open pyeloplasty in 100 patients with pelvi-ureteric junction obstruction[J].SurEndosc,2008,22:411-414.
[6]	POULIOT F,LEBEL M H,AUDET J F,et al. Determination of success by objective scintigraphic criteria after laparoscopic pyeloplasty[J].J Endourol,2010,24:299-304.
[7]	魏金星,张雪培,王智勇,等.腹腔镜Anderson-Hynes肾盂离断成形27例报告[J].临床泌尿外科杂志,2006,21(11):823-824.
[8]	高振利,石磊,杨典东,等.腹腔镜结合开放手术在肾盂成形术中的应用[J].中华泌尿外科杂志,2006,27(7):453-454.
[9]	LORINCZ A,KNIGHT C G,KANT A J,et al. Totally minimally invasive robot-assisted unstented pyeloplasty usinthe Zeus Microwrist Surgical System:an animal study[J]. J Pediatr Surg,2005,40:418-422.
[10]	那彦群,郭震华.实用泌尿外科学[M].北京:人民卫生出版社,2009:257-258.