经脐单孔多通道腹腔镜肾盂输尿管成形术(附3例报告)  

Single-port transumbilical laparoscopic pyeloureteroplasty:an initial clinical experience with 3 cases

作　　者：杨波[1] 王辉清[1] 孙颖浩[1] 刘冰[1] 王林辉[1] 许传亮[1] 徐斌[1] 

机构地区：[1]第二军医大学附属长海医院泌尿外科,上海200433

出　　处：《上海医学》2010年第3期214-216,I0002,共4页Shanghai Medical Journal

摘　　要：目的探讨单孔多通道腹腔镜下肾盂输尿管成形术的初步应用和体会。方法2009年7月-10月第二军医大学附属长海医院对3例肾盂输尿管连接部狭窄患者行经脐单孔多通道腹腔镜下肾盂输尿管成形术,2例为右侧,1例为左侧。结果前2例手术在增加1个2mm的针式Trocar,置入2mm的抓钳辅助牵拉下完成肾盂输尿管的吻合,手术时间分别为6.0和5.5h,出血量约为50mL,分别于术后7和8d出院。第3例患者的手术在单孔多通道下一次完成,未增加另外的工作通道,手术时间为8.0h,其中吻合4.0h,出血量约100mL,术后14d出院。结论单孔多通道腹腔镜下肾盂输尿管成形术安全、有效,手术瘢痕小且隐蔽,美容效果及应用前景良好。但因需要特殊的手术器械,术中器械之间有干扰且活动范围小,使缝合比较困难。Objective To summarize our initial clinical experience on single-port transumbilical laparoscopic pyeloureteroplasty. Methods Pyeloureteroplasty was performed on two patients with right and one with left stricture of ureteropelvic junction during Jul. to Oct. 2009. Results The first two patients used an additional trocar of 2 mm needle strocar for retracting to help completing the Pyeloureteral’s anastomosis; the operative time periods were 6.0 and 5.5 h, and the bleeding volume was about 50 mL. The patients were discharged on the 7th and 8th day after operation. The third operation was completed uneventfully and successfully using single port; the operation took 8.0 h and the suturing took about 4.0 h; bleeding volume was about 100 mL; and the patient was discharged 14 days after the operation. Conclusion This new method is safe and effective, with the advantages of less trauma and more cosmetic benefit, and deserves further promotion. However, more specific instruments are demanded to better apply the technique; difficulties still exist in interference of instruments, limited movement of instruments, and suturing and knotting.

关 键 词：腹腔镜 单孔 肾盂输尿管成形术 

分 类 号：R699[医药卫生—泌尿科学]