后腹腔镜下离断式肾盂成形术治疗肾迷走血管压迫导致输尿管肾盂连接部狭窄  

Retroperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction caused by renal crossing vessels

作　　者：吴大鹏[1] 朱国栋[1] 杨志尚[1] 贺大林[1] 

机构地区：[1]西安交通大学医学院第一附属医院泌尿外科,陕西西安710061

出　　处：《现代泌尿外科杂志》2013年第4期365-367,共3页Journal of Modern Urology

摘　　要：目的探讨后腹腔镜下离断式肾盂成形术治疗肾迷走血管压迫导致输尿管肾盂连接部狭窄(UPJO)的疗效。方法回顾性分析15例因肾脏迷走血管压迫导致的UPJO患者的诊断及治疗经过,其中男性11例,女性4例,所有患者均存在患侧腰部胀痛症状,经B超、静脉肾盂造影(IVU)和(或)磁共振水成像(MRU),和(或)逆行肾盂输尿管造影检查明确诊断为UPJO并肾积水,所有患者均行后腹腔镜下离断式肾盂成形术。结果所有患者均顺利完成手术,无1例中转开放手术,术后1例患者出现发热,1例患者出现漏尿,经治疗后均好转,其余患者均无明显并发症出现。术后1月拔除双J管,所有患者均恢复良好。平均随访18月,显示患肾积水显著减少,患者腰痛症状完全消失。结论对包括肾脏迷走血管压迫在内的各种导致UPJO的病因,均可开展后腹腔镜离断式肾盂成形术,该手术创伤小、恢复快,长期随访效果满意。Objective To evaluate the efficacy of retroperitoneal laparoscopic pyeloplasty for patients with ureteropelvic junction obstruction （UPJO） caused by renal crossing vessels. Methods The diagnosis and treatment of 15 patients with uret- eropelvic junction obstruction （UPJO） caused by renal crossing vessels were retrospectively analyzed. Of the 15 patients, 11 were male and 4 female. All patients had the symptom of left flank pain, and were diagnosed as left UPJO and hydronephrosis of left kidney with B ultrasound, intravenous, retrograde or MR urography. All patients underwent retroperitoneal laparoscop- ic pyeloplasty. Results The operations were successfully performed in all patients. 1 patient developed postoperative fever, 1 patient developed anastomotic urine leakage, and they both recovered after appropriate treatment. No major complications were observed in other patients. The ureteral doubled stents were removed from all patients 3 months after the surgery. All pa- tients recovered well with no left flank pain, and the degree of hydronephrosis of left kidney was dramatically decreased during the mean follow-up of 18 months. Conclusion Retroperitoneal laparoscopic pyeloplasty is an effective and minimal invasive surgical treatment for UPJO caused by all kinds of reasons, including renal crossing vessels.

关 键 词：肾迷走血管 输尿管肾盂连接部梗阻 后腹腔镜下离断式肾盂成形术 

分 类 号：R692.1[医药卫生—泌尿科学]