机器人辅助腹腔镜治疗巨输尿管症研究  

Minimally invasive treatment of congenital megaureter by robot-assisted laparoscopy

作　　者：符伟军[1] 张旭[1] 高江平[1] 杜青山[1] 俞鸿凯[1] 韩宇[1] 董隽[1] 马鑫[1] 李宏召[1] 

机构地区：[1]中国人民解放军总医院泌尿外科,北京100853

出　　处：《微创泌尿外科杂志》2013年第6期360-363,共4页Journal of Minimally Invasive Urology

基　　金：国家高技术研发计划(863计划)项目(12AA021101)

摘　　要：目的:探讨机器人辅助腹腔镜治疗原发性梗阻巨输尿管症的安全性和有效性。方法:采用机器人辅助腹腔镜治疗症状性先天性巨输尿管症患者4例,术中在髂总血管处显露巨输尿管并用乳胶带提起,游离输尿管至膀胱狭窄处,机器人辅助腹腔镜下行体内输尿管末端修剪,抗反流输尿管膀胱吻合分别采用黏膜下隧道包埋或乳头植入法。回顾性分析4例手术患者的临床相关资料,包括手术时间、手术相关并发症、术中出血量、术后并发症以及术后住院时间和病理分析结果等。结果:4例手术均获成功,手术时间平均为(164.5±4.44)min,术中失血量平均为(18.75±4.79)ml,术中未出现手术相关并发症,术后引流管拔管时间均为6d,留置导尿时间均为7d,术后住院时间平均为(7.0±0.82)d,术后无明显疼痛症状,无继发出血、漏尿等并发症。术后病理报告均为尿路上皮黏膜慢性炎症。4例患者术后恢复顺利。结论:机器人辅助腹腔镜采用不同的抗反流输尿管膀胱吻合术式是治疗先天性巨输尿管症的安全有效微创方法。Objective:To evaluate the efficacy and safety of robotic-assisted laparoscopic surgery in the treatment of primary obstructive megaureter.Methods:Four patients of symptomatic congenital megaureter underwent the robot-assisted laparoscopic surgery.In the operation,megaureter was exposed at the position around iliac blood vessel and filed with the latex band.Ureter was isolated to the bladder narrow area.Extreme ureter trim and submucosal tunnel encapsulation or papillary implantations anti reflux ureter bladder anastomosis were performed intro-peritoneal by robot-assisted laparoscopy. Clinical data of 4patients after operation were retrospectively analyzed,including operation time,intraoperative complications,intraoperative bleeding volume,postoperative complications,postoperative hospitalization time and pathological results.Results:The operation was successfully performed in 4patients.The mean operation time were(164.5±4.44) min,the mean operative blood loss were(18.75±4.79)ml.There were no intraoperative complications.The postoperative drainage time was 6dand the indwelling catheter time was 7dfor all the 4patients.Postoperative hospitalization time was(7.0±0.82)d.There was no obvious pain,no secondary bleeding or urine leakage after operation. Postoperative pathology reports were urothelial mucosa chronic inflammation for all the 4patients,who recovered well after surgery.Conclusions:Robot-assisted laparoscopy using different anti-reflux ureter bladder anastomosis is a safe and effective approach of minimally invasive treatment of congenital megaureter.

关 键 词：腹腔镜 机器人辅助腹腔镜 先天性巨输尿管症 

分 类 号：R693[医药卫生—泌尿科学]