腹腔镜肾盂成形术中联合输尿管镜取石术  

Transperitoneal laparoscopic dismembered pyeloplasty combined with lithotomy with ureteroscope

作　　者：周守军[1] 翁国斌[1] 李毛毛[1] 许新民[1] 陈光耀[1] 井元恒[1] 

机构地区：[1]浙江省宁波大学医学院附属鄞州医院泌尿外科,浙江宁波315040

出　　处：《中国内镜杂志》2014年第11期1201-1203,共3页China Journal of Endoscopy

摘　　要：目的评价腹腔镜肾盂成形术中联合输尿管镜取石术的可行性及临床价值。方法采用经腹途径施行腹腔镜离断式肾盂成形术联合输尿管镜取石术治疗输尿管肾盂连接部梗阻（UPJO）合并肾盏结石9例。男7例,女2例。重度积水6例,中度积水3例,上盏结石3例,中盏结石4例,下盏结石2例。结果 9例手术均获成功。手术时间120-200 min,平均140 min;出血量40-150 m L,平均70 m L。术后住院时间7-10 d,平均8.2d。术后无漏尿,无结石残留。随访6-12个月,UPJ吻合口无狭窄,肾积水减轻,其中,中度积水2例,轻度5例,肾积水消失2例。肾功能均有明显改善。结论经腹途径施行腹腔镜肾盂成形术中联合输尿管镜取石术疗效确切,有一定临床应用价值。[ Objective ] To evaluate the feasibility and clinical value of transperitoneal laparoscopic dismem-bered pyeloplasty combined with lithotomy with ureteroscope. [Methods] Of the 9 cases of ureteropelvic junction（UPJ） obstruction and renal calyx caliceal stones who underwent transperitoneal lapar0scopic dismembered pyelo-plasty combined with lithotomy with ureteroscope. 7 males and 2 females, of whom 6 had severe hydronephrosis; 3intermediate. Upper renal calyx caliceal stones 3 cases, middle 5 and lower 2. [ Results] The operation was success-ful in all cases, operative time was 120-200 rain , with an average of 140rain, blood loss was 40-150 mL, with anaverage of 70 mL, hospital stay was 7-10 d, with an average of 8.2 d, there was no urine leakage and residual stonesof all cases. Follow-up of 6-12 months showed there was no stricture at UPJ and hydronephrosis was remitted （in-termediate hydrops in 2 cases, mild in 5 and resolution in 2）. Tile renal functions were distinctly improved. [ Con-clusion ] Transperitoneal laparoscopic dismembered pyeloplasty combined with lithotomy with ureteroscope was ef-fective, and deserved further clinical application.

关 键 词：腹腔镜 输尿管镜 肾盂输尿管连接部梗阻 肾盏结石 

分 类 号：R693.4[医药卫生—泌尿科学]