腹腔镜下巨输尿管成形术治疗巨输尿管症(附14例报告)  

Laparoscopical ureteroplasty for treatment of megaureter(Report of 14 cases)

作　　者：何垚[1] 陈湘[1] 齐琳[1] 高宁[1] 李南南[1] 陈志[1] 罗延诚[1] 

机构地区：[1]中南大学湘雅医院泌尿外科,长沙410008

出　　处：《临床泌尿外科杂志》2012年第7期517-519,共3页Journal of Clinical Urology

摘　　要：目的:探讨腹腔镜下巨输尿管成形术治疗原发性梗阻性巨输尿管症的手术方法及其临床应用价值。方法:原发性梗阻性巨输尿管症14例。男9例,女5例,平均年龄29.4(2～63)岁。术前经B超、静脉肾盂造影、逆行插管造影、CTU或磁共振水成像检查临床确诊,均采用腹腔镜巨输尿管成形术治疗。结果:14例手术均获成功,无中转开放手术。平均手术时间155(109～289)min,平均出血量55(30～105)ml。术后平均住院时间10.5(5～20)d。术后1例患者出现尿漏,保持伤口引流管通畅,于7天后尿漏消失。随访6～24个月,静脉肾盂造影检查结果与术前情况对比显示,输尿管梗阻消失,肾积水未见加重或减轻,患者腰部不适症状基本消失或明显好转。结论:腹腔镜巨输尿管成形术治疗原发性梗阻性巨输尿管症是一种安全可行的手术方式,具有创伤小、出血少、恢复快等优点。Objective：To investigate the operative technique and the clinical value of laparoscopical ureteroplas- ty for treatment of congenital obstructive megaureter. Method：Laparoscopical ureteroplasty was performed on 14 patients with congenital obstructive megaureter,9 were males and 5 were females. The age of the patients ranged from 2 to 63 （mean, 29.4） years. The diagnosis was set up by ultrasonography, IVU, CTU or magnetic resonance urography. Result： All operations were completed laparoscopieal｜y,without conversions to open surgery during op- eration. The mean operative time was 155（range 109 to 289）min. The mean blood loss was 55（range 30 to 105）ml and the mean postoperative hospital stay was 10.5（range 5 to 20）d. Urine leakage occurred in 1 patient and with a good drainage, urine leakage disappeared in 7 days. At the follow-up ranging from 6 months to two years, comparison of the results of IVU demonstrated that all the obstruction disappeared,hydronephrosis was alleviated or un- changed. The lumbodynia was disappeared or improved. Conclusion：Laparoscopical ureteroplasty is a feasible meth- od for treatment of congenital obstructive megaureter for its minimum invasion,less blood loss and rapid postoperativerecove.

关 键 词：输尿管成形术 腹腔镜 巨输尿管 

分 类 号：R699.4[医药卫生—泌尿科学]