后腹腔镜下离断性肾盂成形术治疗肾盂输尿管连接部狭窄  

Retroperitoneal laparoscopic dismembered Anderson-Hynes pyeloplasty for ureteropelvic junction obstruction

作　　者：范志强[1] 刘中华[1] 周瑞锦[1] 姬彤宇[1] 杜涛[1] 

机构地区：[1]河南省人民医院泌尿外科,河南郑州450003

出　　处：《中国内镜杂志》2010年第7期754-756,共3页China Journal of Endoscopy

摘　　要：目的探讨后腹腔镜下离断性肾盂成形术即Anderson-Hynes手术治疗肾盂输尿管连接部梗阻的疗效。方法采用后腹腔镜下Anderson-Hynes手术治疗肾盂输尿管连接部梗阻(UPJO)所致中、重度肾积水患者26例。病程1周～5年,均为腰部钝疼不适就诊,所有患者均经影像学明确UPJO诊断。结果后腹腔镜An-derson-Hynes手术耗时150～300min,平均3h,术中出血35～80mL。无中转开放手术。术后4～7d拔出腹膜后引流管,切口均一期愈合,术后8～10周拔出D-J管,无漏尿及吻合口狭窄,随访3～24个月,B超及静脉肾盂造影(IVP)提示积水改善、肾功能恢复。结论后腹腔镜Anderson-Hynes手术在手术创伤、住院时间、术后恢复等方面优于开放手术,有望替代开放术式。【Objective】To evaluate the feasibility,reproducibility and morbidity of retroperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction.【Methods】A total of 26 extraperitoneal laparoscopic pyeloplasties with Anderson-Hynes technique were performed. All patients had radiographic evidence of obstruction with signs and symptoms. 【Results】All of the 26 extraperitoneal laparoscopic pyeloplasties with Anderson-Hynes technique were performed successfully,and no serious complications occurred during and after the operations. Average operating time was 3 hours,which decreased with surgeon experience. Average blood loss was 60 mL. In no case was conversion to open surgery necessary. Mean follow-up was 15 months. Postoperatively,all of the 26 patients demonstrated improved drainage with no evidence of obstruction on diuretic renography and/or excretory urography.【Conclusions】Extraperitoneal laparoscopic pyeloplasties with Anderson-Hynes technique seems to be a valuable alternative to open pyeloplasty for UPJO. The method appear a safe,effective and minimally invasive procedure for treatment of UPJO. The long-term outcome must be assessed before this procedure may be definitively validated.

关 键 词：后腹腔镜 肾积水 肾盂输尿管连接部狭窄 

分 类 号：R693.2[医药卫生—泌尿科学]