后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部狭窄（附22例报告）  

The Treatment Of Ureteropelvic Junction Obstruction By Dismembered Pyeloplasty Assisted By Retroperitoneal Laparoscopy （22 Cases Report）

作　　者：井汉国[1] 王腾春[1] 申英平[1] 吕振环[1] 张淑燕[1] 

机构地区：[1]山东泰山医学院附属聊城市第二人民医院泌尿外科,临清252600

出　　处：《国际泌尿系统杂志》2010年第2期156-158,共3页International Journal of Urology and Nephrology

摘　　要：目的探讨腹膜后腹腔镜离断式肾盂成形术治疗肾盂输尿管连接部（UPJ）狭窄的操作技巧和临床效果。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UPJ狭窄22例。男15例，女7例。年龄15～50岁。B超检查重度肾积水8例、中度12例、轻度2例。IVU检查：30min内显影良好8例，30～120min淡显影14例。结果22例手术均获成功。手术时间80～155min，平均105min；出血量20～110ml，平均45ml。术后住院时间5～11d，平均7．5d。术后尿漏1例，保守治疗治愈；UPJ吻合口狭窄1例，输尿管镜扩张治愈。每3月复查IVU或B超，随访3～48个月，所有患者IVU检查肾功能显著改善，30min内显影良好18例，30～120min淡显影4例；B超检查肾积水消失7例，肾积水减轻13例，肾积水稳定2例。结论后腹腔镜下离断式肾盂成形术创伤小、操作不复杂、效果肯定，可望成为肾盂输尿管连接部狭窄首选治疗方法。Objectives To invetigate the oprating skills and clinical efficiency of dismembered pyeloplasty assisted by retroperitoneal laparoscopy for ureteropelvic junction（UPJ） obstruction. Methods 22 cases with UPJ were treated by dismembered pyeloplasty assisted by retroperitoneal laparoseopy. Among 22 cases , 15 cases were man and 7 cases were woman. The age were from 15 years old to 50 years old. 8 cases were sevious hydronephrosis,12 cases were middle hydronephrosis and 2 cases were mild hydronephrosis by B ultrasonic. 8 cases had good visullization in 30 min and 14 cases bad low visallization in 30 - 20 min by IVU examination. Results 22 cases were operated successfully. The operating time were 80 ~ 155 min and the avarage time was 105 min. The blood loss were 20 - 1 10ml and the avarage was 45ml. The length of drainge and hospital stay were 5 - 11 day and the avarage was 7.5d. 1 case occurred urinary leakage and was cured by traditional treatment. 1 case occurred anastonmotic stricture and was cured by ureteroscopy dilatation. 22 cases were examined by IVU and B ultrasonic every 3 months and were followed 3 - 48 months. The renal function of all of the cases were obviously improved by IVU and 18 cases had good visullization in 30 rain and 4 cases had low visullization in 30 - 120 min. Hydronephrosis disappeared in 7 cases, decreased in 13 cases and stabilized in 2 cases by B ultrasonic examination. Conclusions Dismembered pyeloplasty assisted by retroperitoneal laparoscopy are little injury, simple operation and effective and can become the first treatment method of ureteropelvic junction obstruction.

关 键 词：肾上腺肿瘤 嗜铬细胞瘤 

分 类 号：R699[医药卫生—泌尿科学]