腹部小切口腹腔镜下离断式肾盂成形术13例  

Transperitoneal Laparoscopic Dismembered Pyeloplasty Combined with Minor Abdominal Incision in Treatment of Ureteropelvic Junction Obstruction(Report of 13 cases)

作　　者：万里军[1] 雷樟铭[1] 童炎岳[1] 葛峰[1] 徐存志[1] 高文君[2] 

机构地区：[1]浙江省衢州市人民医院泌尿外科 [2]浙江省杭州市第二人民医院泌尿外科

出　　处：《中国中西医结合外科杂志》2007年第6期529-531,共3页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

摘　　要：目的:探讨腹部小切口腹腔镜下离断式肾盂成形术治疗肾盂输尿管连接部梗阻的临床疗效。方法:共治疗13例。经腹腔途径腹腔镜下充分游离出肾盂和输尿管上段,仔细观察肾盂输尿管连接部,剪断狭窄段的远端,将一个穿刺孔延长至4cm左右,直视下进行肾盂输尿管吻合。结果:13例手术均获成功,无围手术期并发症。术后随访1～23个月,吻合口无狭窄,肾积水减轻,肾功能有不同程度改善。结论:本术式安全、有效,适合在刚开展腹腔镜手术的医院推广。Objective To assess the feasibility and effect of transpentoneal laparoscopic technique combined with minor abdominal incision in dismembered Anderson-Hynes pyeloplasty in the treatment of ureteropelvic junction （UPJ） obstruction Methods Thirteen patients with UPJ obstruction underwent dismembered Anderson-Hynes pyeloplasty with treansperitoneal laparoscopic technique combined with minor abdominal incision. The pelvis and upper ureter were dissected under laparoscopic transperitoneally, then the pyeloplasty and the anastomotic stoma were performed through an expanded trocar-mcisiott. Results Operations were all successful in 13 cases. The mean operation time was 104 min （range, 75- 180 min）, and the mean blood loss was 60 ml （range 30- 150 ml）, the mean hospitalization was 9 d （range, 7- 12 d）. No perioperative complication was observed. All the 13 patients were followed up from 1 m to 23 m by IVU and B-ultrasound. No obstruction of the anastomotic stoma was found,, but hydronephrosis was remitted and renal functions were improved. Conclusion The tmnsperitoneal laparoscopic tectmique comtined with minor abdominal recision in dismenrbered pyeloplasty is an effective and safe way to treat UPJ obstruction.

关 键 词：腹腔镜 肾盂输尿管连接部梗阻 肾盂成形术 

分 类 号：R692.7[医药卫生—泌尿科学] R616.2[医药卫生—外科学]