后腹腔镜下聚丙烯网带经腰肌肾固定术治疗肾下垂（附15例报道）  

Retroperitoneal laparoscopic nephropexy with Polypropylene mesh belt for nephroptosis （report of 15 cases）

作　　者：胡阳军 王丰 汪波 张杰 龚仕旁 闵霞 

机构地区：[1]武汉市江夏区第一人民医院泌尿外科,湖北武汉430200 [2]湖北崇阳县人民医院泌尿外科,湖北咸宁437500

出　　处：《国际泌尿系统杂志》2015年第2期262-265,共4页International Journal of Urology and Nephrology

摘　　要：目的 探讨后腹腔镜下聚丙烯网带经腰肌肾固定术治疗症状性肾下垂的可行性和疗效.方法 2008年12月以来对15例行立卧位IVU或CT检查确诊为肾下垂患者行后腹腔镜下游离肾脏,采用自行修剪聚丙烯网带绕肾脏中下极,经腰部肌群（腹内外斜肌、腰大肌、腰方肌）穿出,并于皮下与肌筋膜缝合固定.结果 15例手术均获成功,无中转开放.手术时间40- 120rin,平均80min.术中术后无并发症发生.随访12-48个月,术后所有患者腰部酸痛症状较术前明显缓解.术前伴有肉眼血尿和反复出现尿路感染的患者,术后症状消失.术后复查IVU均提示患肾复位固定良好.结论 后腹腔镜下聚丙烯网带肾固定术治疗症状性肾下垂技术可行,创伤小,恢复快,安全有效,并发症少,操作简单,疗效确切,是治疗症状性肾下垂的有效术式,值得推广.Objectives To explore the clinical feasibility and efficacy of retroperitoneal laparoscopic nephropexy with Polypropylene mesh belt for symptomatic nephroptosis.Methods RLN has been performed on 15 patients with symptomatic nephroptosis diagnosised by intravenous urographyin supine and upright positions or CT scan since December 2008.The kidney was mobilized retroperitoneoscopically,crossed the Waist muscle groups（Internal oblique、External oblique muscle of abdomen、Psoas muscle、Quadratus lumborum） and fixed to the Subcutaneous fascia with a Polypropylene mesh belt placed in the lower part of the kidney.Results A11 cases were successfu1 with no intraoperative or postoperative complications.Mean operative time was 80min（ranging from 40 to120 min）.During 12 - 48 months follow-up,all patients had an obvious symptom remission of lumbago,no patient had further episodes of recurrent urinary tract infection and macroscopic hematuria.IVU revealed kidneys in the normal region and greatly improved.Conclusions Retroperitoneal laparoscopic nephropexy with Polypropylene mesh belt for symptomatic nephroptosis is feasible,minimally invasive,quicker recovery,safe and effective.It would be a promising option worthy of dissemination.

关 键 词：肾疾病 腹腔镜 聚丙烯类 

分 类 号：R692[医药卫生—泌尿科学]