后腹腔镜下离断式肾盂成形术  

Retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty

作　　者：陈湘[1] 齐琳[1] 齐范[1] 陈合群[1] 顿金庚[1] 唐正严[1] 王桂林[1] 

机构地区：[1]中南大学湘雅医院泌尿外科,长沙410008

出　　处：《中华泌尿外科杂志》2006年第6期394-396,共3页Chinese Journal of Urology

摘　　要：目的探讨后腹腔镜下离断式肾盂成形术的临床应用价值。方法采用经后腹腔途径实施腹腔镜下离断式肾盂成形术治疗肾盂输尿管连接部(UPJ)梗阻25例。男22例,女3例。B超检查：肾盂扩张积水＜15 mm(轻度)4例,15～30 mm(中度)15例,＞30 mm(重度)6例。IVU检查：30 min内显影良好16例,30～120 min淡显影6例,120 min未显影3例。结果25例手术均成功。手术时间150～240 min,平均170 min；术中出血量30～120 ml,平均70 ml；术后住院时间6～8 d,平均7 d。未发生明显外科并发症。25例术后均随访3～14个月,IVU显示UPJ吻合口无狭窄,肾功能显著改善,30 min内显影良好22例,30～120 min淡显影3例。肾积水明显减轻,肾盂扩张积水消失16例,轻度6例,中度3例。结论后腹腔镜离断式肾盂成形术微创、安全、有效、术后恢复快,可望作为UPJ梗阻治疗的有效手术方法。Objective To investigate the clinical application of retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty. Methods Twenty-five patients （22 men and 3 women） with ureteropelvic junction （UPJ） obstruction underwent retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty. B-ultrasonography showed hydronephrosis 〈 15 mm （mild） in 4 cases, 15 - 30 mm （moderate） in 15 cases, 〉30 mm （severe） in 6 cases. IVU showed good imaging in 16 cases within 30 min,light imaging in 6 during 30 - 120 min,and no imaging in 3 in 120 min. Results The operation was successful in all 25 cases. The operative time was 150 -240 min with a mean of 170 min. The blood loss was 30 - 120 ml with a mean of 70 ml. The postoperative hospitalization was 6 - 8 d with a mean of 7.5 d. No surgical complication occurred during or after operation. Follow-up ranged from 3 to 14 months. IVU showed no UPJ stricture ;and showed good imaging in 22 cases within 30 min,light imaging in 3 cases during 30 - 120 min. Hydronephrosis was remitted （hydronephrosis resolution in 16 cases,mild in 6,and moderate in 3 ）. The renal function was improved in all the cases. Conclusions Retroperitoneal laparoscopic Anderson-Hynes dismembered pyeloplasty has advantages of minimal invasion ,safety ,good effects, and postoperative rapid recovery. It will become the best method for treating UPJ obstruction.

关 键 词：肾盂输尿管连接部梗阻 腹腔镜 

分 类 号：R699[医药卫生—泌尿科学]