腹腔镜Lich-Gregoir输尿管再植术治疗小儿膀胱输尿管反流(附15例报告)  

Laparoscopic Lich-Gregoir ureteral reimplantation for vesicoureteral reflux in children(report of 15 cases)

作　　者：韦华玉[1] 周辉霞[2] 申州[2] 马立飞[2] 梁建波[1] 

机构地区：[1]广西壮族自治区人民医院泌尿外科,广西南宁5300212 [2]北京军区总医院附属八一儿童医院泌尿外科,北京100070

出　　处：《中国内镜杂志》2014年第6期607-611,共5页China Journal of Endoscopy

摘　　要：目的评价腹腔镜Lich-Gregoir输尿管再植术治疗小儿膀胱输尿管反流的治疗效果。方法回顾分析15例原发性膀胱输尿管反流患儿,年龄6个月-9岁,反流III°～IV°,其中双侧4例。穿刺腹腔内建立二氧化碳（CO2）,气腹,于脐下置入5 mm目镜鞘管（Trocar）并固定,两侧放置5 mm操作鞘管。切开膀胱浆肌层约3cm,包埋输尿管形成膀胱逼尿肌隧道,术后留置导尿3～5 d。结果 15例均经腹腔镜完成手术。无中转开放手术。所有病例手术时间45～160 min。术后2例出现血尿,2日后消失。术后随访6～24个月,1例双侧输尿管包埋术后患儿出现右侧输尿管膀胱吻合口梗阻,术后6个月再次行腹腔镜输尿管再植术（乳头吻合）后梗阻缓解。1例仍存在膀胱输尿管反流I°,因无泌尿系感染、定期随访。结论腹腔镜Lich-Gregoir输尿管移植手术治疗膀胱输尿管反流是一种安全有效的手术,术后恢复快,具有微创优势。[ Objective ] To review the efficacy of laparoscopic Lich-Gregoir ureteral reimplantation for vesi- eoureteral reflux. [Methods] We analyze 15 cases （aged from 6 months to 9 years） vesicoureteral reflux （III to V） were analyzed. In all the patient, 15 cases suffered from vesieoureteral reflux （4 in bilateral sides）. A trocar （5 ram） was inserted through umbilicus into abdominal cavity, other 2 trocars （3 mm） were inserted from two sides. The elec- trical surgery unit was used to cut muscular layer. Detrusor tunnel is approximately 3 era. And postoperatively ,a Fo- ley catheter was inserted to drainage during three to five days postoperatively. [ Results ] All procedures were com- pleted without open operation. The duration of operations ranged from 45 rain to 160 rain. All patients were followed up from 6 to 24 months, 1 patient had vesicoureteral obstruction, and 1 patient had vesicoureteral reflux, and no the urinary tract infection was successfully controlled by anti-infectious treatment. [ Conclusion ]The laparoscopic Lich- Gregoir ureteral reimplantation is satisfy,effective.

关 键 词：腹腔镜 膀胱输尿管反流 输尿管再植 

分 类 号：R726.9[医药卫生—儿科]