肋缘下横切口离断式肾盂输尿管成形治疗小儿先天性肾积水21例  

Treatment of pediatric congenital hydronephrosis by Anderson-Hynes pyeloplasty with transverse incision under costal margin:report of 21 cases

作　　者：谢云峰[1] 付承忠[1] 程支利[1] 

机构地区：[1]四川省内江市第一人民医院泌尿外科,四川内江641000

出　　处：《西南国防医药》2011年第6期607-608,共2页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨肋缘下横切口离断式肾盂输尿管成形术（Anderson-Hynes成形术）治疗小儿先天性肾积水的临床价值。方法采用患侧肋缘下横切口,离断式肾盂输尿管成形治疗小儿先天性肾积水21例。所有病例均经静脉肾盂造影和逆行造影诊断为先天性肾盂输尿管连接部梗阻并肾积水,集合系统分离3~10 cm,平均4.5 cm。结果 21例均手术顺利,所有病例均未延长或更改手术方式。手术时间80~105 min,平均98 min,术后无继发出血,继发感染1例,跟踪随访平均18个月,1例出现吻合口狭窄再次出现肾积水合并肾结石形成。结论 Anderson-Hynes成形术具有操作视野显露满意,安全可靠,操作简单,疗效满意等优点,是一种实用的手术方法。Objective To investigate the clinical value of Anderson-Hynes pyeloplasty with transverse incision under costal margin in the treatment of pediatric congenital hydronephrosis.Methods 21 cases with congenital hydronephrosis caused by ureteropelvic junction obstruction（UPJO） underwent Anderson-Hynes pyeloplasty with transverse incision under costal margin on impaired side.They were all diagnosed by intravenous pyelogram（IVP） and retrograde imaging.Renal collecting system of each patient was separated 3-10 cm with an average of 4.5 cm.Results All operations were performed successfully.No incision was lengthened or altered as well as operation procedure.The mean operative time was 98 min ranging from 80 to 105 min;no secondary bleeding was found,and only one case had incision infection.During follow-up of 18 months,just one case of anastomotic stenosis resulting in hydronephrosis and kidney stone occurred.Conclusion Anderson-Hynes pyeloplasty with transverse incision under costal margin is a safe,reliable,easy and practical procedure with good exposure of visual field and satisfactory curative effects.

关 键 词：肾积水 小儿 肾盂输尿管成形术 

分 类 号：R692.2[医药卫生—泌尿科学]