后腹腔镜上半肾输尿管切除术治疗成人重复肾  

Retroperitoneal laparoscopic upper pole nephroureterectomy for duplex kidney in adult patients

作　　者：丁炜宏 苟元成 胡青峰[1] 孙传玉[1] 徐可[1] 夏国伟[1] 丁强[1] 张元芳[1] 

机构地区：[1]复旦大学附属华山医院泌尿外科,上海200040

出　　处：《微创泌尿外科杂志》2013年第1期30-31,共2页Journal of Minimally Invasive Urology

摘　　要：目的:评价后腹腔镜技术进行上半肾输尿管切除术治疗成人重复肾可行性及临床价值.方法:2006年4月～2012年6月,收集分析接受后腹腔镜下上半肾脏输尿管切除术治疗的成人重复肾患者27例临床资料.术中充分游离上半肾后,分别分离结扎上半肾输尿管、动静脉,尽量完整切除上半肾,并用2-0 VICRYL线8字缝合肾脏切缘.术后3、6个月复查泌尿系B超,KUB+ IVU,随访术后肾周情况及肾功能.结果:27例手术均获得成功,无中转开放手术.平均手术时间146 (100～280) min,平均出血120(50～260) ml,术后复查肾功能未见明显改变,无尿漏、尿性囊肿等并发症发生.住院时间6～9 d,平均7d.27例患者术后3～6个月均行B超及KUB+IVP检查,下半肾输尿管形态功能正常,无肾周积液.结论:后腹腔镜上半肾输尿管切除术治疗成人重复肾创伤小,是一种安全、有效的方法.Objective:To evaluate our surgical techniques and experience with retroperitoneal laparoscopic upper pole nephroureterectomy duplex kidney in adult patients.Methods:A total of 27 adult patients with duplex kidney underwent laparoscopic upper pole nephroureterectomy.Retroperitoneal approach was used in all of our patients.The upper pole renal parenchyma was completely mobilized and then we mobilized and transected the ureter,renal artery and renal vein respectively. The upper pole renal parenchyma was divided circumferentially from the lower kidney using an endo-scissors,and the parenchyma was closed by running suture with 2-0 Vicryl.Renal ultrasonography and IVU were performed on 3 and 6 months postoperatively to evaluate the renal function.Results:All laparoscopic operations were performed successfully without conversion to open surgery.The mean operative time was 146 minutes.The mean blood loss was 120ml.No intraoperative or major postoperative complications occurred.The mean postoperative hospital stay was 7 days.The ultrasound and IVU of 3 and 6 months postoperatively demonstrated normal renal function and no perirenal fluid collection.Conclusions:Retroperitoneal laparoscopic upper pole nephroureterectomy is a safe and effective procedure and an excellent minimally invasive treatment option for the adult patients with duplex kidney.

关 键 词：后腹腔镜 重复肾 部分肾脏输尿管切除术 

分 类 号：R572[医药卫生—消化系统]